Frequently asked questions

You don’t have to do anything, your GP or practice nurse will give us your details and we will invite you for your screening appointment.

We will simply take some photographs of the back of your eyes. We will use eye drops to make your pupils larger, so that we get the best possible photographs.

You are advised not to drive for four hours following the eye drops, therefore it is essential that you make alternative arrangements for your journey home.

If you drive to your appointment you may be refused screening as we follow best practice guidance and are unable to screen patients who have driven to their appointment.

You will receive a leaflet – Your guide to diabetic eye screening – giving you more information about screening with your appointment letter.

Within six weeks you will receive your results after two trained and experienced graders have independently looked at your photographs.

If you have no diabetic retinopathy or background diabetic retinopathy, you will be screened on an annual basis. It is essential that you attend your diabetic reviews to ensure optimum control of your blood levels.

If diabetic retinopathy is detected, we will refer you for assessment or treatment with a specialist eye doctor at either Conquest Hospital or Eastbourne DGH, whichever is the closest to your home.

If diabetic retinopathy is found, you will receive – Your guide to Diabetic retinopathy – with your results letter.

We have screening clinics at the following locations:

• Bexhill Hospital
• Arthur Blackman Clinic, St Leonards
• Rye, Winchelsea and District Memorial Hospital
• Princes Park Health Centre, Eastbourne
• Seaford Health Centre (mobile unit)
• Hailsham Health Centre

You should continue to attend your opticians for general eye care and spectacles. Opticians are not part of a national screening programme, which is why your GP or practice nurse will refer you to us to ensure that you are recalled annually or directly referred to the hospital where the doctor can view your photographs immediately, thus enabling prompt assessment and treatment.

If you are over the age of 12 your GP should notify the screening programme as soon as you have been diagnosed with diabetes. Those under the age of 12 do not require screening as they are not at risk of developing diabetic retinopathy.

Once your GP has notified the screening service, the service will invite you to an appointment. If you can’t attend this appointment, please contact us. You should be sent an appointment to attend within three months of being diagnosed or referred.

If you move home, or change GP, we should be notified automatically by your GP. However if you have not received an appointment and are due for your annual screening appointment, please contact us to ensure we have your up-to-date details.

If you change your phone number – either home or mobile, please contact the programme directly.

If you move home and/or change your GP so that your registered GP is not in East Sussex, you will no longer be invited for screening by our programme but by the programme covering your new local area. Your GP or practice nurse can provide you with the details, or you can find out how to contact the screening programme in your area. Please bear in mind that if you have other hospital appointments and move house, you should also update the hospital as well as us, as they will not be notified automatically.

Yes. An eye examination by an optometrist or optician is essential to assess the general health of your eyes, but not all optometrists are accredited to carry out diabetic retinopathy screening.

This means that they do not have the same quality assurance processes in place which all NHS diabetic eye screening programmes have. Quality assurance covers things like the type and specification of equipment, the training of staff, quality of images, and the accuracy of the staff assessing your images for changes (for example, in a screening programme a percentage of all ‘normal’ images are reviewed by one other member of staff, and any ‘abnormal’ images which show some changes are also reviewed by at least two members of staff.

We would therefore recommend that you attend your annual diabetic eye screening appointment as well as your local optometrist.

This depends on whether your eye doctor is examining your eyes for diabetic changes or not, and if they are willing and able to let the programme know the results of this. If you are seeing an eye doctor for another condition such as Glaucoma, to be on the safe side, you should also attend for your annual diabetic eye screening appointment.

If you have already been diagnosed with diabetic changes to your eyes and are seeing an eye doctor for treatment/or monitoring and we have also sent you an appointment, please contact us. It is probable that you do not need to attend for diabetic eye screening as well, but we need to know about this so we can update your details.

Hospital transport can be provided subject to the normal eligibility criteria for people who would otherwise find it difficult to attend hospital. In order to have your eyes screened you will need to be able to sit upright in a chair and rest your chin on the chin rest of the screening camera. If you use a wheelchair you may need to be able to transfer from the wheelchair to a different chair that enables us position on the chin rest of the camera which enables us to take the photographs.

If, for whatever reason, we cannot perform photography in our screening clinics, then you can have another appointment to have your eyes examined in another clinic using a different piece of equipment. If you feel you fall into this category, please contact us to discuss this further, as it will ensure that you do not attend the wrong sort of appointment for your needs.

If you are unable to sit upright, or are the carer of a person who is unable to sit upright, please contact us. In the vast majority of situations screening is not possible, nor is an examination in the eye department available as an alternative however we would like to discuss this with the patient, their carer and their GP.

Home visits are not offered due to the equipment that is used. If you are able to attend the clinic and can sit upright, we are able to screen you in the screening programme. If not, please contact us to discuss this.

First and foremost – come to your screening appointments. We are here to detect diabetic eye problems before you notice a drop in your vision, so they can be monitored and treated as soon as possible. If you wait for diabetes to affect your vision before you come to see us, then we may detect very serious problems which are much harder to treat and may be irreversible.

Good diabetic control is essential to prevent, or minimise diabetes affecting your eye sight and potentially causing sight loss. Your GP or practice nurse is responsible to help you achieve good diabetic control, and you should discuss this with them. If you have not done so, discuss going on an education course with your GP or practice nurse, as this may help you to manage your diabetes more effectively.

Yes. During pregnancy, diabetes can cause changes to occur much more quickly than they might normally so we would like to see you every three months instead. You should have your eyes screened early on in your pregnancy, usually at your first antenatal appointment with the diabetes specialist nurse or doctor, and then every three months during your pregnancy. Please make sure each time you attend that the person screening your eyes knows that you are pregnant.

Some women who do not have diabetes can develop hyperglycaemia (high blood sugar) during pregnancy. This is known as gestational diabetes. Pregnant women who develop gestational diabetes are not offered screening for diabetic retinopathy.

You can make an informed choice to opt out of screening. Please contact us to discuss this. We require you to sign a form and return this to us. We also suggest you only sign the form having discussed this with your GP, and being fully aware of the consequences that delayed diagnosis of diabetic changes could have. Opting out is valid for three years, at which point we would start inviting you to screening unless you opt out again.

We would strongly advise against opting out, as it may place you at an increased risk of diabetic eye problems and avoidable sight loss.

If there is a particular reason or barrier which prevents you attending screening, please contact us to discuss this as we may be able to help.

Those involved in the administration of the programme. Those who are carrying out the screening process (including putting in the eye drops, checking vision, taking your history, taking photographs of your eyes and grading the photographs. These are either staff employed by the acute trust or other NHS body OR are optometrists, self-employed ophthalmologists or staff employed by independent companies. The programme will provide you with a list of non-NHS personnel and companies if you are concerned in any way about who will see information about you and you should let the programme staff know if you have any particular concerns about any particular individual or company.

If your case is referred to the hospital for further assessment the information about you will be forwarded to the hospital so that those who will be looking after your case can have as much information about your history as possible.

In order to make sure that the programme is operating effectively from time to time its work is assessed by clinical auditors and others involved in quality assurance. They may need to have access to your data. In addition efforts will be made nationally to carry out research using fully anonymised data to try and identify as precisely as possible how best diabetes should be managed in the long term (some examples may be how many people have diabetic retinopathy in any area or how quickly it progresses in different groups of people). Any efforts to use any identifiable information would result in us working with the Patient Information Advisory Group to make sure that all necessary agreements are obtained.

Occasionally problems may occur in the software which is necessary to support the programme. Normally the software supplier will not need to see any information that is identified to a specific individual, but occasionally it may become necessary to supply basic information to ensure that the correct information is maintained by the programme securely. Software suppliers who work with the NHS are bound by requirements of confidentiality and should be supervised by NHS staff if they need to look at information that is linked to a named individual. Your results and screening information will be sent to your GP.

Dilation drops are used by our team to allow more light into your eyes and ensure we get clear photographs. If we take photographs without using drops we may find dark patches or shadows on the photos. These photos sometimes do not meet the quality standards we need to screen your eyes safely.

Even if you do not want the drops, please do attend your screening appointment. Let us know why you do not want them, and we may be able to support you in having the drops. Often a brief discussion with the screener can help ease any worries you may have.

We would always recommend that you have the eye drops administered to minimise the risk of diabetic eye changes not being detected. However, we will never force you to have the drops against your wishes. Unfortunately if you decline them we will not be able to proceed with the screening. National guidance now states that a screening episode in the NHS diabetic eye screening programme requires dilation, non-dilation is no longer an acceptable method of screening.

Every GP practice in our catchment area of East Sussex sends us a list of newly diagnosed diabetic patients and existing diabetic patients who have moved into the area. This lets us keep an up-to-date record of all the diabetic patients in our area, so we can offer all of them screening.

Sometimes, especially when you are first diagnosed with diabetes, words like ‘pre-diabetic’ and ‘borderline’ may be used by your GP or practice nurse. Also, you may not be given any diabetic medication, as some people can manage their diabetes without medication. This does not mean that you do not have diabetes, so we still want to screen you, as any diabetic patient can develop diabetic eye problems.

We cannot provide any information or interpretation of your blood test results or diabetic status, as we invite you solely based on what your GP tells us. Therefore, if you have any queries or questions about whether you are diabetic or not, please discuss these with your GP.

The only information that the programme will have about you at the beginning will be your name, date of birth, contact details, NHS number, details of your GP, information to help establish your preferred language and contact method and whether you might need large print documents and the fact that you have been diagnosed as having Type 1 or Type 2 diabetes. Once you agree to have your eyes screened then it will be necessary to be able to check on the results on any previous screening event. It might be that the programme would like to have further information about your medical history relating to your diabetes (such as your blood sugar levels, blood pressure, foot checks, smoking history etc, but not sensitive information so that those who are assessing you have a more complete picture about what is happening.

If you contact the department to confirm your screening appointment it will be taken that you are consenting for that sort of data to be given to those involved in screening and assessment both in the programme and in the acute trust. However if you do not wish this further information to pass to the programme then you should let the programme staff know when confirming your appointment for screening. This will not prevent your eyes being screened but would mean that staff are less able to assess your case as carefully.