This year marks the 10th anniversary of Diabetic RetinaScreen, one of the HSE's national screening service programmes.

As a complication of type 1 and type 2 diabetes, diabetic retinopathy can cause the blood vessels in the retina to leak or become blocked and damage a person’s sight, this risk increases with the duration of living with the condition.

However, if retinopathy is caught early, treatment is effective at reducing or preventing damage to the sight, hence the importance of regular screening.

The first person was screened by Diabetic RetinaScreen in March 2013, with a further 6,000 screens carried out that year. Since then, over 800,000 screening tests have been carried out, and the service is now screening over 100,000 people each year, in over 130 community-based screening locations nationwide. Those diagnosed with diabetic eye disease can receive treatment in seven treatment centres across Ireland.  

Of those screened, over 7,000 are referred each year for further tests or treatment and over 1,000 of these are referred for urgent diabetic retinopathy treatment. There are currently 230,000 active participants registered with the programme, which is around 75% of an estimated total population with diabetes in Ireland.

After the initial rollout of screening, digital surveillance eye screening was introduced in 2017 and extended in 2021. Digital eye surveillance can provide more frequent monitoring for people whose screening test has shown changes in the retina. In 2021, the programme also launched a new two-year pathway for screening, which meant that those with two previous screens without any changes detected were invited to come back in two years time instead of yearly screening as per the initial programme.

In January 2023, the programme also initiated a pilot screening programme for women with diabetes who become pregnant. This programme was nationally rolled out in June this year.

There are now four pathways of screening for those with diabetes:

• Routine digital screening and slit lamp biomicroscopy: Participants will be offered a screening appointment annually to check for any signs of retinopathy

• Digital surveillance: Participants that have some level of retinopathy will be placed in the digital surveillance pathway which offers more frequent screening. This is a six-monthly pathway; participants will be screened at six-month intervals and their retinopathy will be more closely monitored

• Two-yearly screening: Participants with a result of no retinopathy for two consecutive years will be recalled on a two-yearly screening recall basis

• Screening women with diabetes who become pregnant: Pregnant women with pre-existing type 1 and type 2 diabetes can have an increased risk of progression of diabetic retinopathy. Women with pre-existing diabetes should therefore be screened for diabetic retinopathy regularly during pregnancy.

For more information, current guidelines (Clinical Practice Guidelines for Treatment Clinics, 2022) or to refer patients, see www.diabeticretinascreen.ie