In Bexley this screening is carried out by optometrists. The digital cameras and software required to carry out screening have been installed in four optometric practices across the PCT and diabetic screening using the digital cameras started in January 2007. Linklaters is one of the locations chosen to run this service and we have refurbished the practice to include a Diabetic Retinopathy Screening Suite and waiting area.
Digital screening has advantages over the old slit lamp system in that we have a permanent record of images and can therefore monitor any changes over time. Any images our optometrists feel are abnormal are transmitted electronically to a team of ophthalmologists at The Princess Royal University Hospital in Farnborough where they are assessed, along with a proportion of the normal images for quality control purposes. All images are stored on a central computer server sited at the screening centre in Bromley |
|
|
Diabetic Retinopathy
When diabetes affects the small blood vessels on the retina (the film at the back of the eye), this is called diabetic retinopathy.
In its early stages, diabetic retinopathy does not affect your vision, but as changes progress eventually your sight will be affected.
You are at increased risk of developing retinopathy if:
- You have had diabetes for a long time
- You have high blood pressure
- Your blood glucose level is poorly controlled
- You take insulin
- You are pregnant
- You smoke
Why is it important to screen for diabetic retinopathy?
Untreated diabetic retinopathy is the leading cause of blindness in the working-age population. Screening involves regularly examining your eyes to detect the specific changes of diabetic retinopathy that could affect your sight (sight threatening retinopathy) and referring you to an eye clinic for further assessment and treatment if necessary. Any treatment (usually laser) is much more effective if carried out early; at this stage your vision may not be affected. By the time your vision is affected, diabetic retinopathy is fairly advanced and then laser treatment is far less successful.
Do all people with diabetes need to attend screening?
Yes. All people with diabetes who are over the age of 12 need to have eye screening. This is true regardless of whether you are diet, tablet or insulin controlled and whether you attend a hospital diabetic clinic or see your GP.
Will I still need to have eye examinations?
Yes. The screening programme is only designed to detect diabetic retinopathy and does not always detect other eye conditions. No assessment of your spectacle prescription is made during the screening appointment so it is important that you attend for an eye examination every 1 to 2 years as directed by your optometrist. All people with diabetes are entitled to NHS funded eye examinations as well as diabetic screening.
How do I make an appointment?
Appointments for diabetic screening are sent to people with diabetes by the PCT who are based in Bromley; our practice teams have no access to the appointment lists. Therefore any queries about appointments should be made to the team on the following phone number: 020 8776 3854.
Appointments for regular eye examinations may be made in the normal way by contacting the practice.
How will my eyes be screened?
The optometrist will take some clinical details and your visual acuity (standard of vision); it is helpful if you bring your spectacles with you.
You will need eye drops to enlarge (dilate) the pupils in order to take good quality photographs; the drops sting for a few seconds and take 20–30 minutes to work. The drops will blur your vision for a few hours so it is sensible not to drive following your appointment. Once your pupils are dilated you will have photographs taken of your retina using a digital camera; these photographs are then assessed by the optometrist. If the photographs are not clear enough to be assessed accurately, for example if you have cataract, the optometrist may also examine your eyes manually using slit lamp biomicroscopy. Any abnormal images and a percentage of normal images are then assessed by an ophthalmologist at Farnborough Hospital.
If your eyes are healthy you and your GP will receive a letter to this effect and you will be sent another screening appointment in a year.
Some patients may receive an appointment to attend a hospital eye clinic if the photographs show sight threatening retinopathy that requires follow up or treatment by an ophthalmologist, or if other eye conditions are detected by chance during screening that require further investigation.
For some patients, although they may not need to visit an eye department, their retinopathy may be at a level where they need to be screened more frequently. In this case, they will receive appointments for screening more regularly.
If you have any problems with your vision in between screening appointments it is very important you consult you optometrist. Please do not wait for your next screening appointment.
How can you help keep your eyes healthy?
To help stop diabetic retinopathy developing it is important that you:
- Attend for diabetic screening when sent an appointment
- Keep your blood glucose, cholesterol and blood pressure levels as normal as possible
- Maintain a healthy diet and take regular exercise. It is important that you do not smoke.
Other useful websites:
Diabetes UK: www.diabetes.org.uk
Royal National Institute for the Blind: www.rnib.org.uk |
