Diabetic eye screening service
The North Central London (NCL) Diabetic Eye Screening Programme (DESP) is the only provider of NHS specialist diabetic eye screening in NCL, testing to check for risk of damage from diabetic retinopathy.
All newly diagnosed patients with diabetes should be referred to NCL-DESP as soon as possible.
NCL-DESP is provided by North Middlesex University Hospital NHS Trust and conducts a quality assured screening at 13 locations across the five boroughs of NCL (Barnet, Camden, Enfield, Haringey and Islington.)
Eye screening is a key part of your diabetes care, and if you are diabetic, 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, a condition that can lead to sight loss if it's not treated. Screening is a way of detecting the condition early before you notice any changes to your vision.
If diabetic retinopathy is detected early enough, treatment can stop it getting worse. Otherwise, by the time symptoms become noticeable, it can be harder to treat and your sight could be damaged.
Diabetic retinopathy occurs when diabetes affects small blood vessels, damaging the part of the eye called the retina. When the blood vessels in the central area of the retina (the macula) are affected, it is known as diabetic maculopathy.
Coronavirus (COVID-19) and diabetic eye screening
Guidance to keep you safe when attending your screening appointment
As a result of the NHS responding to the coronavirus pandemic, you may have waited longer than normal for your diabetic eye screen.
It is important that you now attend your screening test. Delaying your screening further may put you at increased risk of developing diabetic retinopathy (eye disease or sight loss).
Travelling to and from your appointment
When traveling to and from your appointment, please follow the government guidelines. For more details, go to www.gov.uk and search ‘staying safe outside your home’.
Wearing a face covering
In line with government advice, when attending your appointment, you must wear a face covering. For guidance on how to wear and make a face mask, visit www.GOV.UK and search for ‘face covering’.
At your appointment please be aware:
- Your appointment may not be at your usual venue
- Social distancing measures will be in place in the screening clinic
- Staff may be wearing protective clothing to protect you and them
- The screening appointment may take longer than usual.
If you or any member of your household is suffering from any of the symptoms associated with COVID-19 or are self-isolating as outlined on the government website, please DO NOT attend the appointment.
If you have been shielding because you are clinically extremely vulnerable and you have concerns about the arrangements for your appointment, please contact us.
Similarly, if you are unable to attend, please contact our service to reschedule your appointment for a different time. This is important so we can offer the appointment slot to someone else who needs it.
Conditions we treat
All people over the age of 12 years, with a diagnosis of diabetes should attend for an annual diabetic test.
Diabetic eye screening involves taking photographs of the back of your eyes, once a year, to detect any early changes (diabetic retinopathy) that can occur as a result of diabetes. If left untreated, it can get worse and cause some loss of vision, or blindness in severe cases.
Booking your appointment
All people with diabetes aged 12 and over who live in Barnet, Camden, Enfield, Haringey and Islington should ensure they attend a free diabetic eye screening test with our specialists every year.
All patients, with a diagnosis of diabetes, will be referred to this programme 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 are concerned that you have been told that you have diabetes and have not heard from us, the number to call is 020 8887 2352.
If you cannot attend an appointment, please be sure to tell us well in advance so that we can rebook your it for another convenient time and to allocate your slot to another patient.
Please call us on 020 8887 2352 or email us.
How to prepare for your visit
- When you attend for screening, it is important that you attend on time so that we can ensure waiting rooms do not become overcrowded and social distancing can be maintained.
- Please bring your usual distance glasses with. You may also like to bring sunglasses to wear to go home as everything may look very bright
- It is important that you do not drive yourself to this appointment as the eye drops used during this test cause blurred vision for between two and six hours.
- The clinician will take a brief medical history, undertake a vision test and administer eye drops which will take approximately half an hour to take effect. During this time you will return to the patient waiting area. You will be recalled and photographs will be taken of the back of your eyes.
- You will receive the results by letter, within three weeks of your screening test and your GP will be sent the results at the same time as these are sent to you
Refer a patient
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 pediatric 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 NCL-DESP Gestational Guidelines for further clarity.
How do I refer my patients?
GPs in North Central London are requested to refer all patients newly diagnosed with diabetes to NCL-DESP as soon as possible. Referrals can be made using the referral form [INSERT REFERRAL FORM] here and email it to the team.
NCL-DESP also endeavors to collect the diabetic GP registers on monthly basis, using GP2DRS. Please ensure that the details of all your patients with diabetes aged 12 and over are put onto the practice electronic patient register, with the appropriate coding. All patients on this list will be invited for screening.
Frequently asked questions (FAQs)
- Do all people with diabetes need screening?
- Would I still need to go to my local optician?
- What if I am already attending a hospital eye clinic?
- Do the eye drops have any side effects?
- Can I drive to or from my appointment?
- What if I’m still experiencing discomfort after six hours?
- What does it mean if I get called back?
- What should I do if I notice a problem between appointments?
- How can I reduce the risk of getting diabetic eye disease?
- I am pregnant, what do I do?
Yes, all people over the age of 12 years, with a diagnosis of diabetes should attend for an annual diabetic eye screening test.
The only exception to this would be for patients with diabetes who are already attending a hospital eye service and are under the continuing care of a medical retina clinic.
Yes. The invitation letter we send to all our patients will advise people to continue to see an optician for their routine sight test. The patient leaflet which is sent out with the initial invitation also reiterates that the screening test does not replace the normal eye sight test.
If you are under the care of a hospital eye service (HES) for the management or treatment of diabetic eye disease, and we are in regular receipt of your results you may not need to attend for a diabetic eye screening test.
However, if you are being seen for any other eye condition, including cataract, macular degeneration or glaucoma, it is still important that you attend for your diabetic eye screening test.
In order that we can obtain good clear images of your eye it is necessary for us to use eye drops (1% tropicamide). The drops may cause stinging but this should wear off after a few seconds, however your sight may be slightly blurry for between 2-6 hours and will affect your ability to drive.
No. You should not drive for six hours after your appointment. This is because the eye drops cause blurred vision for between two and six hours.
If, after six hours, you are still experiencing pain or discomfort, you should contact your GP. At evenings or weekends, contact your local accident and emergency department.
Very rarely, the eye drops used for screening can cause a sudden rise in pressure within the eye. This only happens in people who are already at risk of developing this problem at some point in their lives. However, when it happens it needs prompt treatment in an eye unit. The symptoms of a sudden pressure rise in the eye are:
- pain or severe discomfort in your eye
- redness of the white of your eye
- constantly blurred sight, sometimes with rainbow haloes around lights.
If you experience any of these symptoms please attend your local accident and emergency department.
If the photographs, taken at your visit, show signs of diabetic eye disease, a second qualified person will check the photographs. If the signs are confirmed and sight threatening, an eye specialist will look at the photographs. You will then be called to a hospital eye service (HES) eye clinic.
If the signs of diabetic eye disease are present but not threatening your sight, you may need to have more photographs taken to monitor the eye changes at a shorter interval than the normal 12 months.
Occasionally, the images taken are not of high enough quality to make a decision regarding the presence or absence of any diabetic eye disease. If this is the case we will call you back for a further test using different equipment, allowing us to make a final decision. You will receive a letter telling you of the recommendation.
Information for patients who require more frequent monitoring.
If you notice problems with your eyes between screening visits do not wait until your next appointment but get advice urgently or visit your local A&E hospital.
There are things that you can do to reduce your chances of developing complications:
- have regular check-ups with your healthcare team – at least once a year
- check that your healthcare team does a long-term check on your diabetes, such as an HbA1c test
- test your blood glucose levels at home regularly
- achieve and maintain a healthy body weight
- keep your blood pressure and blood fats (eg cholesterol) under control
- eat a healthy balanced diet
- increase your level of physical activity
- don't smoke.
If we identify that you have diabetic retinopathy you should discuss this with the GP who is looking after your diabetes to improve control of your blood glucose, blood pressure and cholesterol, and preferably avoid smoking.
If you have referable retinopathy identified at a screening appointment you will be referred and should attend for your hospital eye service outpatient appointment.
Women who develop diabetes during pregnancy (known as “gestational diabetes”) do not need to attend for a diabetic eye test.
Women who had a diagnosis of diabetes before they became pregnant, require screening more frequently during pregnancy, as diabetic retinopathy can develop for the first time or worsen more quickly.
Because of this, eye screening is usually carried out at the first antenatal check and again at 28 weeks of pregnancy. Some women will also be screened when their pregnancy reaches 16 to 20 weeks (particularly women who showed some signs of diabetic retinopathy on their first set of photographs).
Please remember, it is important to attend screening as soon as possible after your pregnancy has been confirmed. If you have not received diabetic eye screening during the first 13 weeks of your pregnancy, please contact us.