Retinal screening is now done with digital photography, and all the images are stored electronically on a specific database, which has been purely designed just for diabetic eyescreening. The databases they encompass absolutely everything, from a patients demographics to when the last appointment was, to all the prescreening assessments and the photos, and to the grading and the image analysis as well, so everythings encompassed on one database. We have retinal screeners, and theyre the ones that, they come in and they do all the assessments and they take the photos, and.
We have retinal graders, and theyre the ones that do the image analysis. People with diabetes they should be screened at least once every year. The guideline states that it should be every 12 to 15 months. Its patients responsibility, as well as their GPs responsibility, as well as the responsibility of the programme, to make sure that patients do come along and have their eyes checked. We do inform a GP if weve invited a patient, or if weve appointed a patient and the patient fails to attend, or fails to respond to the invite, then we do inform the GP and let them know that the.
Patient may need a little bit more explanation or a little bit more education, or a little bit more encouragement to understand what their appointments about so they can come and attend the appointments. There are basically four main stages of diabetic retinopathy that we do the image analysis for. The first category is when we dont see any visible diabetic retinopathy, so these are patients that may only have diabetes for a short time, or if theyve had diabetes for a little bit longer, they may be lucky enough not to have any changes in their eyes. With these patients, where theres nothing.
Diabetes Retinal screening from BMJ Learning
Visible, we would do the image analysis, and then the results would go out, and that would tell them that theres no diabetic retinopathy present, and wed inform them and their GP that wed like to see them again the following year. Like I said, its normally 12 to 15 months from the last appointment to the next one. The first stage where we can actually see any diabetic retinopathy happening in the back of the eye is called background diabetic retinopathy. Thats when the first signs of diabetic retinopathy start showing up. The main signs of that are microaneurisms,.
Which are tiny little swellings in the blood vessel, and also little leaks from the blood vessels, which can be different fluids, like blood, or lipids little fatty fluids. Again, if these symptoms are not sightthreatening, so theyre not happening in the area of central vision or likely to cause any damage, then we would notify the patient that there are some slight background changes, but we dont need to see them again until the following year. We would also then inform the GP to make sure that the patients blood sugar.
Levels and blood pressure levels are kept at an optimal level to ensure that there are no further complications. Some of these patients that have background diabetic retinopathy there may also be maculopathy noted. Thats where these changes are in the area of central vision and may affect the persons vision. The fluids there can lead to a bit of waterlogging on the back of the eye, the retina, so that can cause potential oedema, which can be damaging to the vision, and also the exudates the little lipid deposits that Ive mentioned they can also cause damage there.
Any patients that we see that has anything potentially sightthreatening, any maculopathy at all, we would refer onward to a diabetic eye specialist and an ophthalmologist at one of the acute trusts, and they would be able to have a look at them there for further investigation and potential treatment. Diabetic eyescreening is very important, because unfortunately once people notice that they have changes to their vision, so their diabetic retinopathy becomes symptomatic, then it is too late unfortunately, maybe by then the damage will already have been done. Its very important for patients to.