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Digital Retinal Photography for Patients with Diabetes

  • Digital Retinal Photography can be performed by Dr Xydas, using the non-mydriatic camera Topcon NW-100

  • No need to use eye drops (which means that the patient can drive immediately after the examination)

  • Ability to offer "one-stop" clinic (i.e. perform the examination during the usual diabetes consultation)

Digital retinal photography can be offered during the consultation with Dr Xydas. The retinal digital photography is performed using the non-mydriatic TopCon camera NW-100.


"Non-mydriatic cameras" are the newer generation retinal cameras where a digital photograph can be taken without the use of eye drops to dilate the eye. This is achieved by using high quality camera lenses (giving an extra wide capture ability), taking high quality photographs using the normal opening of the eye (pupil). This means that the patient can drive immediately after the photographs of the retina are taken.

Why does a patient require retinal screening?

  • The high sugar seen in Diabetes affects the small blood vessels of the eye (called retinal vessels) resulting in a condition called Diabetic Retinopathy

  • Diabetic retinopathy is the most common cause of visual loss among people with diabetes and a leading cause of blindness among working-age adults.

  • Over time, the small vessels of the eye become more and more fragile leading to:

    • Small bleeding due to this fragility causing injury to the delicate surface of the eye​

    • Vessels become more permeable causing a "leak" of protein & lipid particles forming deposits over the retinal surface (called cotton wool spots or hard exudates)

  • Above changes lead to catastrophic changes to the membrane of the eye, causing swelling and gradual visual loss.

  • It is estimated that once the first changes occur on the surface of the eye blindness could result within 5-10 years. Such blindness can be prevented if prompt action is taken.

  • The main benefit of digital retinal photography are:

    • Such changes can be picked up early, so that the destructive process is halted prevent thus to progression to blindness

    • Having retinal photographs of your eye, means that you could compare the process of the disease using the previous photographs 

What does it mean if I have Diabetic Retinopathy?

  • There are 3 main stages of diabetic retinopathy:

  • Background Retinopathy: This is the very first stage of diabetes eye disease. It usually occurs if diabetes has been present for 10 years. It doesn't put your eye-sight in danger, however regular follow up is needed to ensure it doesn't progress to the next stage.

  • Pre-proliferative Retinopathy: This is a stage before the "eye-sight threatening" stage and PROMPT & IMMEDIATE action is needed to halt progression.

  • Proliferative Retinopathy: This is the most crucial stage of diabetes eye disease and some permanent damage of the eye is imminent. Immediate referral to a specialist ophthalmologist is needed for appropriate action

  • Having Diabetic retinopathy DOES NOT mean that blindness will occur. It just means that diabetes has causes some changes to the vessels of the eye. There are multiple therapies that can be applied to prevent progression of the eye changes, and in many cases reversal of the condition could occur. Such actions include:

    • Tight and aggressive glucose control​

    • Strict blood pressure control

    • Special injections inside the eye to slow down the progression (called anti-VGEF therapy)

    • Laser therapy to the eye

  • Such therapies are effective especially if diabetes retinopathy is picked early. Since diabetic retinopathy is asymptomatic, it is very important to have a regular retinal photograph

How frequent do I need to have Retinal Photograph?

  • The frequency of the retinal photography is based on the stage of any pre-existing eye disease. The frequency of the screening is set by international guidelines which is summarised on the table below:

  • No pre-existing retinal disease: Retinal screening should be done every 12 months

  • Background Retinopathy: Retinal screening should be done every 12 months

  • Pre-proliferative Retinopathy: Retinal screening should be done every 4 months and if stable every 6 months.

  • Proliferative Retinopathy: Immediate referral to specialised ophthalmology services is required

  • Special Situations:

    • Type 1 or Type 2 Diabetes in pregnancy: ​Retinal screening is required EVERY TRIMESTER

    • Gestational Diabetes: No retinal screening is required

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