March's Minutes

Sarah welcomed everyone to the meeting, recapping on volunteering opportunities in the upcoming months.

This month’s guests were Nikki Crowley and Hayley Lewis from the Diabetic Retinopathy Screening Services for Wales (DRSSW).

The DRSSW was formed about 12 years ago following an initiative from the Welsh Government, before then there was no consistency across Wales regarding eye care. The idea of the DRSSW was to form a regulated service to monitor eye care of people with diabetes.

Diabetic retinopathy is the study of the back on the eye, called the retina which, with regular screening can detect minute changes. The DRSSW screen everyone with diabetes, children with diabetes are screened from the age of 12, however the patients with Gestational Diabetes are not screened as gestational diabetes can sometimes disappear following the birth of the baby.

The DRSSW are based at their headquarters in Treforest where all the grading of the images takes place. The retinopathy team travel in pairs with a clinician and a photographer, the clinician administers the eye drops and asked all the relevant background questions regarding blood pressure, smoking, there is then a 20-minute waiting period before being called back in to have the photographs of the back of the eyes taken, the photos are saved to a laptop which on return to the headquarters in Treforest are then downloaded to the main grading office. At the point of taking the photographs the photographer will make an initial assessment and grade the photographs as either Red or Amber. The red labeled photographs are assessed the following morning.

Retinopathy is small changes to the retina in the form of tiny bleeds that look like tiny pin pricks. The grading department are situated in a darkened room and grade the photographs, they are displayed as two images, a colour image and a black and white image which can show the retinopathy up much clearer.

The grading team then arrange for the results letters to be sent to patients. The headquarters in Treforest are responsible for sending out the invitation appointment letters. They are responsible for keeping the 181,000 people with Diabetes in Wales on a register and keeping that register up to date.

Diabetes is such a condition that can be left undetected in the body for 10 years, during this time with it being uncontrolled it can cause problems with sight. Retinopathy can detect changes in the back of the eye, these pictures are saved so that they can be used as a comparison in future appointments, retinopathy is such that the changes can disappear between appointments or alternatively appear between appointments.

New research is being carried out to detect if it is beneficial to change the period between appointments to two yearly. The research behind this is hoping that if you have two appointments that have shown no changes then it is likely that you will be put on a two yearly recall rather than a yearly recall.

The DRSSW do not just screen people with Type 2 Diabetes, children are added to the register when they are diagnosed however screening does not start for them until the age of 12.

The screening service only look at the retina of the eye and not the eye as a whole which is why it is important to maintain appointments with your optician.

The optician is uniquely placed that if they detect problems at your regular appointment that they can refer you directly into the hospital.

Control of your diabetes can affect your chances of developing retinopathy, bad control can cause the raising of blood glucose which can cause tiny bleeds in the eye, not enough to affect your eye sight straight off, however if you notice problems such as blurred vision it is important to make an appointment at the opticians as they can refer you straight into the hospital.

Early detection can increase your chances of getting the correct treatment, such as laser treatment.

Sudden changes in weight, for example stomach banding can cause a sudden increase of blood glucose and can make the retinopathy worse before it can get better.

Pancreatic transplants are being monitored to see what changes to retinopathy occur.

In the coming months there are plans to pilot a combination appointment in that you have the eye drops administered and then in the 20-minute wait time for the drops to work their best, it is being piloted that during that 20 minutes your annual foot check be carried out. This is being piloted in the Cardiff and Vale Health Board.

You may be finding that your appointments are coming slowly however the retinopathy team are reliant on the generosity and availability of venues, sometimes GP surgeries, there are plans to look at creating fixed sites manned by clinicians and photographers who are local to those sites, for example, if there were to be a fixed site in Newport it would be manned by a clinician and photographer who were local to Newport. It would mean that these fixed sites would be able to offer appointments from earlier in the day to later in the evenings.

Following your retinopathy appointment, the drops should wear off in approximately 4 hours but it is important to shield your eyes from bright sunlight and refrain from driving.

If you have a true allergic reaction to the eye drops it would be sudden onset of eye swelling and would become very red, it is important that if this were to happen that you visit your optician or Accident and Emergency Department to have your eyes examined


***** A true allergic reaction to the eye drops used is Very Very Rare*******


It is important that you attend the appointments when you are called for your screening, it is vital for your sight.

From this year, following working with Diabetes UK Cymru, your retinopathy appointment will be accompanied by a copy of the 15 Healthcare Essentials.

Our next meeting is Thursday 21st April, we will be having a talk from the Diabetic Specialist Nurses for the Newport East and Newport West Cluster of GP’s.