What do my results mean?

Possible screening results are:

• No retinopathy
• Background retinopathy
• Degrees of referable retinopathy (Routine or Urgent)
• If digital images are not clear enough to allow the image of your retina to be graded, then a second test using a method called slit lamp biomicroscopy will be required.

The profile of the different levels of retinopathy is illustrated within the pie chart below. The vast majority of results are no retinopathy or background retinopathy, both of which do not require a referral to the hospital eye service for further examination. The section below headed The Grading Classification – provides examples of retinal images for each of the grades.

If we identify that you have background diabetic retinopathy you should discuss this with the GP who is looking after your diabetes to optimise 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.

The grading classifications

When we are reviewing your retinal images they will be classified as one of the following:

No diabetic retinopathy (Images appear normal)

This is a good finding and means that on the images we assessed we could not see any features that caused concern.

Background diabetic retinopathy (Background Changes)

This finding means that small changes were spotted on the images we assessed. However, we could not see any features that caused any concern. Retinal features sometimes appear and disappear from year to year and do not necessarily mean things are ‘getting worse’.

Diabetic maculopathy (Routine Referral)

This means that small changes were found on the images within the macular area. Accordingly the patient will be referred, for safety, to the hospital eye service for further investigation. Patients should expect to be seen within thirteen weeks.

Preproliferative diabetic retinopathy (Routine Referral)

This means that changes were spotted on the images we assessed. The changes are seen as a finding that needs further investigation. We will refer the patient to the hospital eye service for further investigation. Patients should expect to be seen within thirteen weeks.

Proliferative diabetic retinopathy (Urgent Referral)

This means that larger changes were spotted on the images we assessed. The changes need prompt further investigation. We will need to refer more quickly than normal as these changes could cause damage if not assessed by the hospital eye service. Patients should expect to be seen within six weeks.

Non diabetic eye diseases & What happens next?

On occasion, as a result of attending your diabetic eye screening test, we will find other non-diabetic eye conditions.  Some of the conditions may require a referral to the hospital eye service. Others we will report direct to your GP practice, as they may already be aware of the condition.

Although these features may have nothing to do with diabetic retinopathy, the patient will be referred for a hospital eye service appointment if this is required.

Unassessable Results & What happens next?

There are several reasons why a patient may get an unassesable result from the screening examination One example is that the lens of the eye can get too cloudy to see the back of the eye; this may be because of a cataract, please see image below.

In this circumstance we will refer you for a Slit Lamp Examination.  A slit lamp is a lamp which can produce a slit beam of light which can be shone into the patient’s eye and this allows a specialist to assess whether there are any problems.  Patients should expect to be seen within thirteen weeks.

Below is an example of a patient who developed a cataract over a period of three (3) years until they had the cataract removed in 2010.

2006

2007

2008

2009

2010
After removal of cataract