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Changes to diabetic eye screening

NHS Scotland is in the process of implementing changes to the Diabetic Eye Screening (DES) programme. The change process started in October 2020 and the changes are outlined below, including the addition of Optical Coherence Tomography, (OCT), to the programme.

Revised screening intervals

Following scientific evidence, the UK National Screening Committee recommends that people with diabetes at low risk of sight loss should be screened for diabetic retinopathy (DR) every two years, instead of every year.

People who are at high risk of sight loss should continue to receive annual or six-monthly screening.

How will the DES programme determine who is at low or high risk?

A person's previous screening history will be used to determine whether they are deemed low risk of sight loss.

The move to two yearly screening will be phased in, with some people at low risk being transferred over to two yearly intervals immediately and others being transferred over after their next screening test.

How has the pause to the DES programme affected these planned changes?

The DES programme was temporarily paused between March and August 2020 because of COVID-19. This pause, as well as the social distancing measures now required in clinics, means that the programme is currently running approximately six months behind.

Those deemed at low risk of sight loss based on their previous screening history are now being moved across to two-yearly intervals. This will help us to prioritise people most at risk of sight loss as we catch up after the pause. 

Incorporating OCT into the Diabetic Eye Screening Programme

Sometimes an optical coherence tomography (OCT) scan is needed to detect macular oedema (MO), which is the leading cause of moderate sight loss in people with diabetes.

The Scottish Screening Committee has recommended that OCT surveillance is formally incorporated into the DES programme.

This will happen on January 1 2021 and will mean OCT will generally be delivered by DES teams instead of ophthalmology. This should reduce patient waiting times for OCT and allow ophthalmology clinics to be used more effectively.