What to expect during diabetic eye screening

Dr Enslin Uys, an ophthalmologist, describes the process of diabetic eye screening step-by-step and goes on explaining why it is vital.

What is diabetic eye screening?

Diabetes can cause health problems in several ways and your eyes are one part of your body that can be affected. Diabetic eye screening is a test to check for eye problems caused by diabetes.

Diabetic retinopathy is caused by diabetes. This can lead to loss of vision (ultimately blindness) if it’s not found early.

The eye screening test can find problems before they affect your sight. Pictures are taken of the back of your eyes to check for any changes.

If you have diabetes and you are 12 years or over, you should have your eyes checked at least once a year.

Diabetic retinopathy

This condition occurs when uncontrolled blood glucose levels affects small blood vessels, damaging the part of the eye called the retina. It can cause the blood vessels in the retina to leak or become blocked. This can affect your sight.

Diabetic retinopathy

Importance of screening

Diabetic eye screening using direct ophthalmoscopy
Diabetic eye screening using slit lamp examination.
Diabetic eye screening using indirect ophthalmoscopy
Diabetic eye screening using indirect ophthalmoscopy.
Diabetic eye screening using digital photography
Diabetic eye screening using digital photography.

Eye screening is an important part of your diabetes care. Untreated diabetic retinopathy is one of the most common causes of sight loss. When the condition is caught early, treatment is effective at reducing or preventing damage to your sight.

Diabetic eye screening is not covered as part of your normal eye examination with your GP or even some opticians. Screening doesn’t look for other eye conditions and you should continue to visit your optician regularly for an eye examination as well.

How can I reduce the risks?

You can reduce your risk of developing retinopathy, or help to stop it from getting worse by:

  • Controlling your blood glucose level.
  • Tightly controlling your blood pressure.
  • Controlling your cholesterol levels.
  • Keeping fit and maintaining a healthy weight.
  • Give up smoking. Nerve damage, kidney and cardiovascular disease are more likely in smokers with diabetes. Plus, smoking increases your blood pressure and raises your blood glucose level, which makes it harder to control your diabetes.
  • Get regular retinal screening. The most effective thing you can do to prevent sight loss due to diabetic retinopathy is to go to your retinal screening appointments by an eye specialist, also called an ophthalmologist. Early detection and treatment can stop you from losing sight. If you’re pregnant and have gestational diabetes, you will require retinal screenings more often during your pregnancy and after your baby is born.

The process of the screening test

Eye drops being administered prior to screening test

  1. Drops will be administered in your eyes to temporarily make your pupils larger. You may find the drops sting a bit and the eye drops may affect your vision for a few hours, so you shouldn’t drive after your appointment.
  1. Photographs will be taken of the back of your eyes. The camera doesn’t come into contact with your eyes. If the screening test isn’t performed by an ophthalmologist, the photographs will be sent to one.
  2. The appointment will last around 30 minutes.
  3. A feedback letter will be sent to you and your GP within six weeks letting you know your screening results.


Possible results

An ophthalmologist will study the photographs of your eyes after you have been screened. If there are any problems or more questions, we may call you back for another assessment.

Screening can detect:

  • Early signs of retinopathy.
  • If you need a follow-up appointment to see whether you need treatment.
  • If you need to have more frequent checks.

Practical tips for the screening day

  • Bring your glasses and contact lenses you wear along with lens solution for contacts.
  • Bring sunglasses as your eyes can feel sensitive after the eye drops.
  • You may want to bring someone with you to the appointment.
  • Eye drops may affect your vision for a few hours, so you shouldn’t drive after your appointment.

Remember, eye screening is part of managing your diabetes and diabetic retinopathy is treatable, especially if it’s caught early.


Dr Enslin Uys (MBChB; DA (SA); Dip Ophth (SA); FCOphth (SA)) is a general ophthalmologist with a strong interest in disease affecting the retina. He is the co-founder of the Pietermaritzburg Eye Hospital, where he is currently in full time private practice, and is the current president of the South African Vitreoretinal Society (SAVRS) that represents ophthalmologists in SA involved in treating and managing retinal diseases.

Header image by Adobe Stock
Images supplied by Dr Enslin Uys