Diabetic retinopathy: eye screening and when to refer
The short answer
Everyone with diabetes needs a dilated retinal examination when diabetes is diagnosed and regularly after that, because diabetic retinopathy causes no symptoms until it is advanced. Refer straight away when there is new vessel growth, a bleed into the eye or sudden loss of vision, and soon for maculopathy or more than mild changes.
Refer a patientMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Who to refer
- Anyone with diabetes who has never had a retinal examination, or not in the past year.
- People with diabetes who notice blurred or distorted central vision, new floaters or a sudden drop in vision.
- Women with diabetes who are pregnant or planning pregnancy, when retinopathy can progress faster.
- People with diabetes whose blood glucose has been brought down quickly, or whose blood pressure or kidney function is poorly controlled, who have any retinopathy.
How urgently
Same day
Sudden loss of vision, a vitreous haemorrhage, signs of retinal detachment, or new vessels with a bleed.
Soon
Proliferative changes without a bleed, maculopathy or suspected macular oedema, or severe non-proliferative changes. Within days to two weeks.
Routine
A first retinal examination for someone with no symptoms, or mild background changes for review.
What to send with the referral
- The type of diabetes, how long the person has had it, and the latest HbA1c if you have it.
- Blood pressure, kidney function and lipid results if known.
- Visual acuity for each eye, and your retinal findings or photographs.
- Pregnancy, or plans for it.
- Current medicines, including insulin and any anticoagulant.
Screening is where most of the sight is saved
NICE recommends that adults diagnosed with type 1 diabetes are referred to eye screening at diagnosis. The same principle holds for type 2: the retina should be examined from the start, because changes can already be present.
A GP or pharmacist who sees a patient with diabetes who has not had an eye check is in the best position to start it. A referral for a first retinal examination is a good referral.
What you get back
- An acknowledgement email with the referral reference as soon as you submit.
- A loop-back letter from the receiving clinician once the patient has been seen: what was found, what was done and the plan.
- The patient returned to you for ongoing care, with the plan in the letter, so you keep the person you looked after.
- A named specialist and a care coordinator who calls the patient, so the referral does not sit unanswered.
Mezo pays nothing for referrals: no fee, credit, points or discount per patient, to anyone. You refer because it is the right place for the patient, and you hear back how it went.
Refer a patient
For diabetic retinopathy treatment, laser and injections or an assessment. No Mezo account needed. The receiving specialist and a care coordinator take it from here.
Common questions
My patient has perfect vision. Do they still need a retinal check?
Yes. Diabetic retinopathy usually causes no symptoms until it is advanced, so good vision does not rule it out. That is why examination is offered from diagnosis.
What will I get back?
A letter with the retinal grading, any treatment given and when the next check is due, so you can remind the patient and keep their diabetes care joined up.
Does Mezo pay referrers?
Mezo pays nothing for referrals: no fee, credit, points or discount per patient, to anyone. You refer because it is the right place for the patient, and you hear back how it went.
Guides to send your patient
Patient health guides
The treatment
More referral guidance
Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Diabetic retinopathy: management and monitoring (NG242). National Institute for Health and Care Excellence, 2024. Clinical guideline.
- Type 1 diabetes in adults: diagnosis and management (NG17). National Institute for Health and Care Excellence. Clinical guideline.
- Diabetic Retinopathy Preferred Practice Pattern. American Academy of Ophthalmology, 2024. Clinical guideline.
- Understanding diabetes-related eye conditions, including diabetic retinopathy. The Royal College of Ophthalmologists. Patient information.
- Diabetic retinopathy. NHS. Patient information.
Links last checked 23 October 2026.