Diabetic eye screening is an important part of diabetes care. People with diabetes can be at risk of developing a condition called Diabetic Retinopathy (DR) which affects the blood vessels on the retina at the back of the eye. This condition, when left untreated, can lead to sight loss. The diabetic eye screening programme aims to identify this condition early, often before any symptoms are even noticeable, allowing early treatment which can prove to be very effective and significantly reduce the chances or degree of sight loss.

Eye Screening Test

The eye screening test is done by photographing the retina at the back of the eye. The test is relatively simple and involves a short eye test (Visual Acuity (VA)) and then administration of dilation eye drops. These drops are used to ensure the patient’s pupil is dilated enough to allow a clear image of the retina to be captured.

Once images have been captured the appointment is complete. Their images are then triaged immediately and enter a grading queue to be assessed by a qualified member of staff. Depending on what is identified, images may require a second or even third (higher) level of grading, which will be carried out by a senior grader or ophthalmic lead for the final say and to decide an outcome.

Results will then be issued to the patient and to their registered GP practice to be added to their records and/or for any further care from the patient’s primary care team. 

The entire appointment usually only takes around 30 minutes to complete, which is including 15-20 minutes for the drops to take effect, (but this may vary between patients). The grading process can take longer to complete, due to the requirement for multiple staff to assess the images on occasion, but we aim to issue results within 3 weeks of the patient attending a screening appointment.

Eligibility

Diabetic eye screening is for all people with diabetes, over the age of 12.  The Barnsley and Rotherham DESP provide eye screening for all those eligible registered in our catchment area, which is any GP practice falling under the Barnsley or Rotherham ICB.

Further guidance on eligibility for DESP can be found here: Diabetic eye screening: cohort management - GOV.UK

Types of retinal screening

The Barnsley and Rotherham DESP manages patients through 3 main pathways.

Routine Digital Screening (RDS)

This pathway is used to screen most people with diabetes, who have no, or very minor (background retinopathy), signs of diabetic eye disease. On this pathway patients will be recalled every 12 or 24 months. Anyone new to the service will initially be invited for a RDS appointment. Patients continue to receive invitations for screening in this pathway until they are referred onto another screening pathway or moved off register.

Extended Screening Intervals in RDS

From October 2023 extended screening intervals were phased in by the Barnsley and Rotherham DESP in line with the latest national guidance. This has been introduced after the UK NSC recommended the change to 2 yearly screening for those considering at low risk of sight loss. In order to meet the criteria for 2-year screening intervals a patient must attend two consecutive successful screening episodes in the RDS pathway with a final DR grading of R0M0 in both eyes in both episodes. This is on track to be fully implemented by October 2025.

Digital Surveillance (DS)

This pathway is used to monitor patients who are:

·       Known to have some level of diabetic eye disease and may require more frequent screening

·       Patients discharged from Ophthalmology for not attending a diabetic eye consultation with medical retina consultant

·       Pregnant people with diabetes also require increased frequency of eye screening on this pathway during the gestational period.  We work closely with Diabetes Specialist Midwifery and Obstetrics teams to offer screening as per the latest guidelines for pregnant women.

OCT in Diabetic Eye Screening

The programme is planning to introduce Optical Coherence Tomography (OCT) imaging within the diabetic eye screening DS pathway. The use of this imaging in addition to the current retinal colour photographs provides more accurate results, allowing those less at risk of sight loss or not requiring treatment to be monitored safely in the screening programme, rather than the local Ophthalmology department. 

More updates will be provided in due course, or please contact the programme with any questions.

Slit Lamp Biomicroscopy (SLB)

The SLB pathway is used in DES as an alternative for those who we cannot capture adequate retinal images for. Once image capture has been attempted and is unsuccessful, the patient will be offered another appointment on this pathway, usually within 13 weeks of the original appointment.

Most commonly this pathway is required for patients with non-diabetic eye related eye conditions which affect our imaging, such as cataracts or other lens opacities.

Diabetic eye screening: slit lamp examination explained - GOV.UK

Eligibility

Diabetic eye screening is for all people with diabetes, over the age of 12.  The Barnsley and Rotherham DESP provide eye screening for all those eligible registered in our catchment area, which is any GP practice falling under the Barnsley or Rotherham ICB.

People with diabetes should be referred to the service at the point of diagnosis (proforma for referral included in useful documents below). Referrals can be made from any relevant health professional, but are primarily made by the patients GP Practice/Primary Care team. Both new diagnosis of diabetes and newly registered diabetic patients to GP practice should be referred using the form.

A monthly validation is carried out to identify any patients missing from the programmes register, but has its limitations, so we would always prefer the referral form completing in the first instance, as it makes it less likely for the patient to be missed. Currently there is no automated transfer of patients between screening programmes, therefore we still rely on primary care GPs to ensure everyone with diabetes is known to the service. If ever in doubt please don’t hesitate to contact the service.

Further guidance on eligibility for DESP can be found here: Diabetic eye screening: cohort management - GOV.UK

Useful Links & Documents

Diabetic eye screening - NHS

Your guide to diabetic eye screening - GOV.UK

Your guide to diabetic retinopathy - GOV.UK

Diabetic eye screening: slit lamp examination explained - GOV.UK

Closer monitoring and treatment of diabetic retinopathy - GOV.UK

Diabetic eye screening: use of personal information - GOV.UK

Diabetic retinopathy | Diabetes and eye problems | Diabetes UK

Accessing the service

• Tel: 01226 434576
• Email: barnsandrothdess@nhs.net

Opening Hours

Monday to Thursday - 8:45am to 4:00pm
Friday - 8:45am to 12:30pm

Our aim is to provide a screening appointment that is as convenient as possible, therefore, alongside the fixed screening sites at Barnsley and Rotherham Hospitals, we also attend a number of community venues. Please contact us for further information regarding our community venue locations and clinic details.

Base

Robert Hague Centre for Diabetes and Endocrinology
Barnsley Hospital NHS Foundation Trust
Gawber Road
Barnsley
S75 2EP

Moving to Alhambra Shopping Centre, ‘Health on the High Street’ (Old Wilkinson’s Unit), Late Summer/Autumn 25.

Referral guidelines

Exclusions and Suspensions

Suspensions

Screening may be considered ‘suspended’ for the following reasons:

•             Being under the care of hospital eye services (HES)/Ophthalmology department for management of DR or related diabetic eye disease
•             Under the DS or SLB surveillance pathways as mentioned above

Suspended patients are constantly monitored by the programme’s failsafe function, ensuring these patients are still seen for DR in a timely manner in the appropriate pathway.

Exclusions

Opt Out

 All people with diabetes should be invited for screening but each individual has the right to decline an invitation as they see fit. If this is the case, patients should be directed to opt out directly with the screening service, not with other health professionals. This allows us to ensure the patient is making an informed choice to opt out and understands the risks and benefits of attending/not attending. It also allows us to address any possible barriers to attendance of a screening appointment, and ensure appropriate documentation is completed for audit purposes and appropriate follow up in future.

Medically Unfit

Is used for anyone eligible for the screening programme who is not and will not ever be able to benefit from the screening programme due to pre-existing physical or mental health condition, they can be removed from screening indefinitely as ‘medically unfit’.

The programme will contact the patients registered GP to ensure they have been assessed and for confirmation the exclusion is appropriate.   

Updated:  August 2025