Screening for diabetic retinopathy

Everyone with diabetes should have the back surfaces of their eyes regularly examined, either using photography or at a doctor’s appointment. The aim of this screening is to spot any retinal changes and monitor their progression.

A colour photograph of a healthy fundus.

The purpose of fundus screening photography for people with diabetes is to spot the first signs of retinal changes, monitor any progression, and refer the individual to an ophthalmologist, if necessary, to assess the need for treatment. The objective is to spot any changes that could pose a threat to vision in good time, and thus prevent any visual impairment. In Finland, there are national recommendations for fundus screening photography, based on which photographs of the backs of the eyes should be taken every 1–4 years depending on the type of diabetes and the severity of the retinal changes.

National recommendations for fundus screening examinations in different situations are set out in more detail in the list below. (Source: Current Care Guidelines recommendation)

Individuals with type 1 diabetes, who were diagnosed under the age of 10

From the age of 10-11 years, every two years as long as the examination results remain normal.
After retinal changes have been detected, annually or more frequently.

Individuals with type 1 diabetes, who were diagnosed after the age of 10

At the diagnosis stage and then every other year as long as the finding is normal.
After changes are established, once annually or more frequently.

Individuals with type 2 diabetes diagnosed before the age of 25 years

From the time of diabetes diagnosis, every two years as long as the examination result remains normal.
Thereafter, as for individuals diagnosed after the age of 25 years.

People with type 2 diabetes diagnosed at age 25 years or older

At the time diabetes is diagnosed:
- Immediately upon diagnosis if blood glucose levels are high or there is evidence suggesting that diabetes had been present for several years before diagnosis.
- Otherwise, 1–2 years after diagnosis.
Thereafter, every three years as long as the findings remain normal.
If the major risk factors are well controlled and no retinopathy has previously been detected, every four years.
If there is a marked change in glycaemic control, a retinal examination should be performed earlier and more frequently.
Every two years if mild changes are detected.
Annually or more frequently if more extensive changes are present.

Pregnant individuals with pre-existing diabetes

When planning a pregnancy or as soon as pregnancy begins.
During pregnancy, according to the severity of retinopathy and glycaemic control.
For one year after delivery, more frequently than usual if at least moderate retinopathy changes are detected.

People with gestational diabetes

Fundus screening is not necessary for people with gestational diabetes.

Screening for diabetic retinopathy

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