Diabetic retinopathy / diabetic eye disease

Diabetic retinopathy / diabetic eye disease – Adult

Emergency and immediate referrals

Referral to Emergency Department:

Immediate Referral (seen within 7 days):

Sudden severe visual loss e.g. vitreous haemorrhage, retinal detachment or retinal vascular occlusion

Presenting symptoms
Proliferative diabetic retinopathy (PDR) Assessment of severe non-proliferative diabetic retinopathy threatening vision Macular oedema Vitreous haemorrhage in a person with diabetes

Mandatory referral information (referral will be returned if this information is not included)
Date diagnosed/duration (or estimated if unknown) Diabetes type, duration and HbA1c Details and duration of treatments Most recent optometrist or private ophthalmologist report including: Best corrected visual acuity (BCVA) - vision with most recent distance spectacles Refraction Retinal assessment If unable to attach reports please include relevant information/results in the referral Referrer to state reason if not able to include in referral Note: This information is required to triage accurately, within a clinically suitable timeframe

Mandatory referral information (referral will be returned if this information is not included)

Date diagnosed/duration (or estimated if unknown)
Diabetes type, duration and HbA1c
Details and duration of treatments
Most recent optometrist or private ophthalmologist report including:
- Best corrected visual acuity (BCVA) - vision with most recent distance spectacles
- Refraction
- Retinal assessment
If unable to attach reports please include relevant information/results in the referral
Referrer to state reason if not able to include in referral

Note: This information is required to triage accurately, within a clinically suitable timeframe

Highly desirable referral information
Other relevant optometrist or ophthalmologist reports/results if available and where providing it will not delay care: Optical coherence tomography (OCT) results Blood pressure Fasting blood glucose results Previous eye treatment e.g. retinal laser Fasting lipids results

Indicative triage category

Indicative triage category
Cat 1 Appointment within 30 days	Diagnosis of diabetes and any of the following: proliferative diabetic retinopathy (PDR) vitreous haemorrhage severe nonproliferative diabetic retinopathy (NPDR) assessment of diabetic retinopathy in pregnancy centre involving diabetic macular oedema (Definition: thickening within 500 microns of the foveal centre associated with microaneurysms, haemorrhages or hard exudates)
Cat 2 Appointment within 90 days	Diagnosis of diabetes and any of the following: moderate NPDR non-centre involving diabetic macular oedema (Definition: thickening within 2-disc diameters (but not within 500 microns) of the foveal centre associated with microaneurysms, haemorrhages or hard exudates).
Cat 3 Appointment within 365 days	No category 3 criteria

Cat 1
Appointment within 30 days

Diagnosis of diabetes and any of the following:

proliferative diabetic retinopathy (PDR)
vitreous haemorrhage
severe nonproliferative diabetic retinopathy (NPDR)
assessment of diabetic retinopathy in pregnancy
centre involving diabetic macular oedema (Definition: thickening within 500 microns of the foveal centre associated with microaneurysms, haemorrhages or hard exudates)

Cat 2
Appointment within 90 days

Diagnosis of diabetes and any of the following:

moderate NPDR
non-centre involving diabetic macular oedema (Definition: thickening within 2-disc diameters (but not within 500 microns) of the foveal centre associated with microaneurysms, haemorrhages or hard exudates).

Cat 3
Appointment within 365 days

Excluded ophthalmology services

Referral to public ophthalmology outpatient services is not routinely accepted for the following conditions:

Condition	Details (where applicable)
Routine screening or mild non-proliferative diabetic retinopathy	Except those without a primary photo screening or local optometrist service

Useful Information for referring practitioners

Please refer to the following HealthPathways: Eye Disease Screening in Diabetes
For optometry requests, please refer to the following HealthPathways: Optometry Requests

More information