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Diabetic Eye Screening
From Jan 31st 2011 the diabetic eye screening program in Sheffield will change. The scheme has to change due to shortcomings in the current system – the scheme failed an external audit and alteration was necessary. Talks between the LOC, Hallamshire and PCT to try to get optometrists to be graders as well as screeners eventually came to nothing, and the PCT have decided that screener-graders not involving optometrists is the most cost effective way to go.
People with diabetes will no longer have their eyes photographed within optometric practices; instead they will be invited to attend one of a choice of locations where they will undergo both screening and grading at the same visit. This function will be performed by suitably trained and accredited, non professional staff, in line with other disease screening systems.
The AOP advise that if a patient is being screened as part of a formal screening program, there is no requirement for the optometrist to dilate the patient’s pupils purely for the detection of retinopathy, however you may still wish to dilate the pupils for any other reason.
The College of Optometrists advice states that if the optometrist is not responsible for providing screening locally, he should advise the patient if this appears to be overdue. If you believe that a patient as not been screened within the last twelve months, you should inform the patient and the patients GP that this should be carried out and note this advice on the patient’s record. If you should find diabetic retinopathy you believe wants further attention, please refer via the Referral Information Centre (RIS) in the normal way, unless you are sure the patient is already being seen by the Hallamshire consultants (and is not just on the screening program). It is also in our GOS contract that we must send a letter of information to the GP each time we examine a patient with diabetes. This letter should be sent directly to the patient’s GP rather than to RIS.
The memorandum of understanding on GOS sight test intervals allows a patient with diabetes to have an annual sight test. This is a minimum interval and does not represent an obligation to see these patients annually. You may feel that with annual screening a sight test every two years is adequate. This is a matter for your professional judgement.