Screening for diabetic retinopathy

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6999.207 (Published 22 July 1995) Cite this as: BMJ 1995;311:207
  1. Bob Ryder
  1. Consultant physician Diabetic Unit, City Hospital, Birmingham B18 7QH

    Combined modalities seem to provide the best option

    Diabetic retinopathy is an important cause of blindness,1 and the British Diabetic Association has recently begun a nationwide campaign to increase awareness of the problem. Much blindness due to diabetes is preventable: if sight threatening retinopathy is detected in time then laser treatment can greatly reduce the progression to blindness.2 To detect those patients who require treatment the traditional recommendation is that every one to two years all diabetic patients should be screened either by ophthalmoscopy through pharmacologically dilated pupils or by retinal photography.3

    But concern is increasing that this advice is insufficient and the Department of Health and Social Security in the late 1980s mounted the largest British study of the subject, which recruited 3318 patients to evaluate possible screening modalities.4 This study showed that ophthalmoscopy through dilated pupils (whether by general practitioners, optometrists, or hospital physicians) and retinal photography through undilated pupils both missed between one third and two thirds of cases …

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