Retinopathy 

Retinopathy starts with a background stage. Tiny bulges develop in the capillaries that supply the back of the eye. These may leak slightly, but do not usually affect the vision. If diabetes control is not improved, the pre-proliferative stage follows and the blood vessels become increasingly damaged and cause more bleeding into the eye. 

Finally, the proliferative stage sees the formation on the retina of scar tissue and new blood vessels that bleed easily and impair eyesight. At this stage, there can also be retinal detachment and/or
maculopathy (leakage or blockage of the blood vessels in the central part of the retina). Treatment options include laser therapy, anti-VEGF (vascular endothelial growth factor) injections, steroid implants and vitreoretinal surgery.

Staying healthy and keeping diabetes under control can help reduce the risk of developing retinopathy, but within 20 years of diagnosis, two-thirds of people with type 2 diabetes and almost all people with type 1 diabetes will have some degree of the condition. Regular screening is essential, as is being alert to symptoms such as eye pain, redness, floaters, worsening eyesight or vision loss. People with diabetes are also at increased risk of developing other eyesight problems, such as cataracts and glaucoma, which can lead to impaired vision.

Uptake of eye screening is generally at high levels in the UK, but is lower among young people. Target uptake is 85 per cent. Eye screening is offered from the age of 12, and the young person attends with a parent or carer. In the late teens, young people are less likely to attend and can drop off the radar. 

The current annual screening interval for people with a high risk of sight loss will continue, but work is underway to change from one-year to two-year screening intervals for people classed as being low risk of developing sight threatening retinopathy. 

Patients will be considered low risk if they have had no diabetic retinopathy identified on two successive screening tests. This change is being made after a large observational study showed that it was safe to invite people in this low risk group every two years, rather than annually.