University Hospital Sussex NHS Trust provides NHS diabetic eye screening for all individuals with a GP in the Brighton and Sussex area. All newly diagnosed people with diabetes should be referred to either Brighton and Sussex DESP or West Sussex DESP as soon as possible.
Eye screening is a vital part of your diabetes care, and if you have diabetes, you should make sure you have a specialist diabetic eye screening test every year. This is because your eyes are at risk of damage from diabetic retinopathy, which can lead to sight loss if it is not treated.
Screening is a way of detecting the condition early before you notice any changes to your vision. Otherwise, by the time symptoms become noticeable, it can be harder to treat, and your sight could be damaged.
Important
Do not drive to your appointment. You’ll not be able to drive for at least 4 to 6 hours after your appointment. This is because we will put drops in your eyes which will make your vision blurry.
Referrals to us
Patients should only be referred if:
- they have received a definitive diagnosis of diabetes
- this diagnosis has been discussed with the patient
- patients under 12 years may be referred to the programme but they will not be invited for a screening appointment until after their 12th birthday. In accordance with national guidelines these patients should be seen by paediatrics ophthalmology consultants in a hospital eye clinic.
We cannot accept referrals for patients who:
- have a result indicating IGT (Impaired Glucose Tolerance), borderline diabetes or pre-diabetes.
- if you believe that a patient with any of the above should have a retinal examination, you can refer the patient directly to the ophthalmology team.
- have a diagnosis of gestational diabetes as patients with pure gestational diabetes do not seem to progress to any referable degree of diabetic retinopathy during their pregnancy.
If a patient has gestational diabetes but has possible pre-existing diabetes, then we are happy to add the patient to our screening programme and screen the patient according to the national guidelines as long as the patient’s new status has been updated with their GP. Please see the link for the Gestational diabetes – NHS (www.nhs.uk) Gestational Guidelines for further clarity.
All individuals, with a diagnosis of diabetes, will be referred to us by their GP and once registered with us we will send you annual reminders telling you when and where your next check-up is.
If you have been told that you have diabetes and have not heard from us please contact us.
Your appointment
Once referred, you should get an appointment within 3 months from us. If it has been more than 3 months and you’ve not heard from us, please contact us.
If you’re pregnant and have type 1 or 2 diabetes, your midwife or diabetes nurse or doctor should refer you to us. You’ll be screened in your 1st trimester (or as soon as possible) and 2 to 3 times in total during your pregnancy. Please let us know if you are pregnant but have not had an extra appointment from us.
Changing or cancelling your appointment
If you cannot attend an appointment, please be sure to tell us in advance so that we can rebook your it for another convenient time and to allocate your slot to another patient.
Getting ready for your appointment
Please check your appointment letter for where to go, the date and time of your appointment. If you need more information, please get in touch with us.
What to bring
- Your appointment letter (to check location, date and time)
- If you wear contact lenses, you must take them off when you get to your appointment. Please bring a container and some solution or wear your glasses to the appointment.
- Sunglasses: consider bringing a pair of sunglasses with you to wear home. The drops we put in your eyes can make everything look brighter.
Transport
If you use a wheelchair, have difficulty walking or are housebound, we will ask you to arrange transport, whether it’s hospital transport, a carer or a family member.
Do not drive to your appointment. You’ll not be able to drive for at least 4 to 6 hours after your appointment. This is because we will put drops in your eyes which will make your vision blurry.
Interpreters
If you require an interpreter for any language including British sign language, please contact our department as soon as possible to request that this is arranged.
Pregnancy
Please contact us prior to your appointment, if you are pregnant as you will need to be seen more regularly. Initially, this will be within your first trimester and will then be every three months, including the three months following birth. You will then return to the routine screening programme.
The eye drops we use are Tropicamide 1%, which are safe to use during pregnancy.
Allergies
If you have had a reaction to the dilating drops at your previous appointment, please let us know before you attend your appointment.
There may be limited seating in the waiting area, please try to limit the number of people who come with you to your appointment.
What happens at your appointment
Please arrive no earlier than 10 minutes before your appointment time.
We do not have a reception area at all our clinics. Sometimes you’ll be asked to sit in the waiting area and our staff will come out to check if you’ve arrived. If you have been waiting for more than 15 minutes after your appointment time, please let someone working at the clinic know or call us on 01273 664425.
Our screening technician will:
- call you into a clinic room and check we have the correct details for you
- ask you about your diabetes and your eyes
- check your eyesight, with your glasses on if you wear them. This will take about 10 minutes
- put some drops into your eyes. This makes your pupils bigger to let the camera take a fuller picture of the back of your eye
The drops can take about 20 minutes to work, and you’ll be asked to sit in the waiting area until they start working.
When you are called back in to have your eyes photographed, our screening technician will take about 4 to 6 pictures of your eyes. Unfortunately, our screeners are unable to give you your results straight away.
This short video shows you a simple guide on diabetic eye screening.
What happens after your appointment?
Your results will be sent to you within 2 to 6 weeks after your appointment to explain your results. Unfortunately our screeners are unable to give you your results straight away. We will also send the results to your GP.
Your results
If there are no changes in your eyes, we’ll ask you to come to another screening appointment in 1 year.
- If your results show some early or background diabetic changes affecting your eyes, improving your diabetes management can be essential to stop the changes from developing further. We’ll screen you again in 1 year. We’ll let your GP know, but you should also contact them to review your diabetes care plan. Please read the your guide to diabetic retinopathy leaflet for more information.
- If your results show moderate diabetic changes affecting your eyes, we’ll ask you to come back for another test and will check you more often. You may be asked to have an optical coherence tomography (OCT) scan of your retina so we can check your eyes more closely. Please see the diabetic retinopathy: monitoring and treatment leaflet for more information. This leaflet is also available in other languages.
- If your results show, there are significant diabetic changes affecting your eyes we’ll refer you to a specialist eye doctor for further assessment/treatment.
- If your results show that the images are not clear enough to be graded, we’ll ask you to come back for another type of test. This may be at a different location that has a different method of testing called a slit lamp bio-microscopy (a different equipment that allows us to look at the individual parts of the eye in detail).
Grading classifications explained
Your images will be sent to be graded and classified using the following terms:
- This is means the images were assessed and nothing of concern was found, so you will be invited back next year for re-screening.
- Your test result shows you have some background retinopathy. This means there are small changes to the blood vessels in the retina at the back of your eye as a result of diabetes.
- You do not need treatment at this time and background retinopathy does not affect your sight. However, it is important you manage your diabetes as well as possible to reduce the risk of developing more serious damage in the future. We will inform your GP of your test result and you should talk to them if you have any concerns about your diabetes.
- Your test result showed the effects of diabetes on the blood vessels within the centre of the retina; this may need to be checked further and is called maculopathy. We will be sending you another appointment, within three months, inviting you to attend our digital surveillance clinic, where you will be tested using an OCT machine. The OCT machine provides an enhanced scan of the layers of the retina and allows treatment to given at an early stage before it affects your sight.
- You may return to regular screening if the changes are stable or be referred to the hospital eye service for monitoring and possible treatment.
- It is important that you attend this appointment. We will inform your GP of your test result and you should talk to them if you have any questions. You can also call the screening programme on 01273 664425.
- Your test result showed us that you have pre-proliferative retinopathy. This means there are changes to the small blood vessels in the retina at the back of your eye as a result of diabetes and you are at risk of long-term problems with your sight.
- These changes may need treatment, so we are referring you to the Eye Hospital to see a specialist. The hospital will send you an appointment.
- It is important that you attend this appointment in order to protect your eyesight.
- Your test result showed that you have sight-threatening retinopathy. This means there were serious changes to the blood vessels in the retina at the back of your eye.
- We are referring you to the relevant Eye Hospital to see a specialist who will discuss treatment options. These options may include laser treatment to prevent sight loss. The hospital will send you an appointment within the next few weeks.
- It is important that you attend this appointment in order to protect your eyesight.
- The following can help reduce the risk of your retinopathy getting worse:
- Aim to control your blood sugar levels as well as possible.
- Make sure your blood pressure is monitored regularly.
- Go for regular diabetes checks.
- Sometimes whilst grading, the grader may come across other non-diabetic eye conditions, which may require a referral to the hospital eye service from your GP.
- We will send a letter to your GP informing them of the changes and referral required.
- An unassessable result means the grader was not able to see a good clear image of the back of the eye via photography. This is usually because our view through the front of the eye is obscured by a cataract developing which makes the lens cloudy.
- With this outcome you will be sent to a different clinic location called a Slit Lamp Clinic, this has a special piece of equipment which can see around the lens. The procedure is very similar to the photography visit. For more information please visit the government page on slit lamp examinations.
Our locations and contact details
Useful resources
- National screening leaflets
- Diabetic eye screening
- Brighton and East Sussex Diabetes care teams
- Diabetes UK
- NHS website
- Public health England guide to diabetic eye screening
- DVLA guidance
- Danny’s Story a video from Guy’s and St Thomas’ hospital about a person who is living with sight loss resulting from diabetes
- Read some of our Diabetic Eye Screening Frequently Asked Questions.