Private Diabetic Eye Screening Service
Most Common Types of Diabetes Mellitus:
- Type 1: Inability to produce insulin hormone to reduce the glucose levels, as body attacks the pancreas. Diagnosed before the age of 40 years.
- Type 2: Pancreas does not make enough insulin OR unable to function correctly.
What is Diabetic Retinopathy?
WHY IS IT IMPORTANT TO BE PERIODICALLY SCREENED FOR DIABETIC RETINOPATHY?
Uncontrolled diabetes can have side effects on your eyes even before there is loss of vision and therefore it is always best to be examined regularly to reduce the risk of irreversible sight loss.
Patients with Type 1 Diabetes should undergo Annual Screenings for Diabetic Retinopathy beginning at the latest 5 years after the onset of their disease, whereas those with Type 2 Diabetes should have a prompt screening at the time of diagnosis and screenings thereafter depending on the findings at the time.
WHAT DOES OUR PRIVATE DIABETIC EYE SCREENING INCLUDE AND HOW DOES IT DIFFER WITH THE NHS SCREENING?
A complete assessment of the Retina requires more than Slit-Lamp examination or Photography of only the Posterior Pole or Central Retina.
We therefore deliver this dedicated private Diabetic Retinopathy Screening through Prof. Stanga & his Retina-Specialist Optometrist who has several years-experience as a Diabetic Retinopathy Grader.
We use the most pioneering non-invasive Ultra-Widefield multimodal Imaging Technologies, to ensure ruling out side-effect from Diabetes Mellitus in the entirety of the eye.
Most importantly, we have the capacity to deliver this service much sooner than the NHS and with no cancellations, at a time that is convenient for yourself. We do our utmost to ensure you are seen in a timely manner and without the need for a referral like the NHS, a process that usually takes several weeks before a consultation or treatment can take place.
Our aim is to stabilize or improve your visual function and vision-related quality of life.
The Retina Clinic London performs in-house all necessary diagnostic testing and treatments, both medical and surgical.
|The Retina Clinic London
|Advanced State-of-the-art Imaging Technology to view the eye and assess any diabetic features. Multiple Different Ultra Widefield and Widefield Imaging Technologies are used to image the Retina in detail and in its entirety.
Results are emailed within 1 week to you and/or your GP/Optician at your request. You can yourself then send them to the NHS Diabetic Eye Screening Programme if so you wish.
|Screening performed using only using Two Colour Photo images of only the Posterior Pole or central area of your Retina.
The pictures are graded and results are posted to the patient within 6 weeks
|No GP Referral required.
No delay in screening.
|GP Referral needed.
Appointment with Retina-Specialist Optometrist / Diabetic Retinopathy Grader: £300
- Medical History. Please bring your most up to date HbA1C result, Blood pressure Reading and List of Medications, as available.
- Best Corrected Visual Acuity. Please bring your spectacles, if prescribed.
- Slit-Lamp Biomicroscopy. Examine of the Anterior Segment of the Eye as well as of the Retina.
- Non-Contact Tonometry: Measurement of the Intra-Ocular Pressure.
- Dilation of Pupils. To allow the most complete possible imaging and scanning of the Retina. Your vision may remain blurry for up to 4-6 hours and affect your capacity to drive. You may want to bring sunglasses for after the examination.
- Optos® Multiwavelength Ultra-Widefield Imaging. Non-invasive device that can image up to 200° (approximately 80%) of the Retina in a single image. The scanner uses different light wavelengths (colours of light) that allow a “layer by layer” visualisation of the back of the eye to understand better its integrity and enhance the visualisation of vascular changes, thus more easily and effectively identifying and differentiating Microaneurisms and Haemorrhages as well as New Vessels in the Retina. Most importantly, this is so far the best technology in our opinion to visualise the Peripheral Retina, an area not assessed by the NHS Diabetic Retinopathy Screening. If we compare Optos® Multiwavelength Ultra-Widefield Imaging with current National Guidelines for NHS Diabetic Eye Screening Services, we can see that Digital Photography carried out in the NHS only images the Posterior Pole or Central Retina (40° coverage vertically and 45° horizontally) but not the Peripheral Retina. This coverage is significantly smaller compared to our screening. Ultra-Widefield Imaging provides a more accurate representation of Diabetic Retinopathy disease with greater accuracy in prediction of progression as it can pick up more diabetic lesions. We now know that there is a high association of changes in the Peripheral Retina and progression of Diabetic Retinopathy, hence the importance of imaging it: 3.2x risk of Diabetic Retinopathy and 4.7x risk of Non-Proliferative developing into Proliferative Diabetic Retinopathy.
- Macular Optical Coherence Tomography. Topcon® DRI Triton OCT uses Swept-Source technology to allow increased visualization into the deepest layers of the Retina even through cataracts. This device provides Cross Sectional views of the Macula to identify the presence of Intra or sub-Retinal Fluid as well as Topographic Maps of it to identify areas of Retinal Thickening/Oedema (Swelling).
- Widefield Optical Coherence Tomography. Canon® Xephilio S1 Swept Source OCT is a new technology that allows for the scanning of large retinal areas in Cross-Sectional, Topographic, Angiographic and 3D modes of the Central and Peripheral Retina. This device is the first to be used in the United Kingdom.
- Widefield Optical Coherence Tomography Angiography. In non-invasive non-dye used Angiographic Mode, it provides a Map of the Retinal Blood Vessels and blood supply in a Non-invasive manner. This is an excellent technology to identifying whether your Diabetes is advancing with a reduction of the vascular/blood supply to your Retina.
- High Resolution Anterior Segment Photography: Pre-Dilation Iris and Pupil Margin; Post-Dilation Lens (Oblique and Trans Illumination)
- All the scans, images and results will be evaluated by our Retina-Specialist Optometrist/Diabetic Retinopathy Grader, who will explain the results to the patient. This information will then be reported to the patient and/or GP as per the patient’s preference.
**This appointment will approximately last up to 2 hours**
Full Vitreoretinal Consultation with Prof. Stanga £650
Treatment at TRCL is Patient-Specific. If you require treatment for your Diabetic Retinopathy, Prof. Stanga will tailor your treatment according to your specific needs and this may include a combination of different therapeutic modalities.
**Additional fees: If Optos® Ultra Widefield Digital Fundus Flourescein Angiography is required to rule out Retinal Ischaemia (loss of blood supply) or New Vessel growth £550**
Stanga PE, Pastor-Idoate S, Duvoby S, Vatas P, Reinstein U, Reinstein D, Zahavi O. Navigated Single-Capture 3D and Cross-Sectional Wide-Field OCT of the Mid and Peripheral Retina and Vitreoretinal Interface. European Journal of Ophthalmology. Eur J Ophthalmol. 2021. In Press.
The Royal College of Ophthalmologists’ clinical guidelines for diabetic retinopathy: a summary. Diabetic Retinopathy Guidelines Working Group. Eye (Lond). 2013 Feb;27(2):285-7. doi: 10.1038/eye.2012.287. Epub 2013 Jan 11
Choudhry N, Duker JS, Freund KB, Kiss S, Querques G, Rosen R, Sarraf D, Souied EH, Stanga PE, Staurenghi G, Sadda SR. Classification and Guidelines for Widefield Imaging: Recommendations from the International Widefield Imaging Study Group. Ophthalmol Retina. 2019 Oct;3(10):843-849
New Findings in Diabetic Maculopathy and Proliferative Disease by Swept-Source Optical Coherence Tomography Angiography. Stanga PE et al. Dev Ophthalmol. 2016;56:113-21. doi: 10.1159/000442802. Epub 2016 Mar 15 PMID: 27023703
Optical coherence tomography (OCT): principles of operation, technology, indications in vitreoretinal imaging and interpretation of results. Stanga PE, Bird AC. Int Ophthalmol. 2001;23(4-6):191-7. Review. No abstract available. PMID: 11944840
Ocular manifestations of diabetes mellitus. Stanga PE, Boyd SR, Hamilton AM. Curr Opin Ophthalmol. 1999 Dec;10(6):483-9. Review. PMID: 10662255 RCOph Guidelines
Stanga PE, Muqit MM, Marcellino GR. Comment and reply on: Structural changes of the retina after laser photocoagulation in spectral domain optical coherence tomography. Curr Eye Res. 2010 Mar;35(3):255-6; author reply 257-8
Stanga PE, Muqit MM. Retinal laser photocoagulation, anaesthesia, and pain responses. Eye (Lond). 2010 Aug;24(8):1415-6; author reply 1416-7
Sanghvi C, McLauchlan R, Delgado C, Young L, Charles SJ, Marcellino G, Stanga PE. Initial experience with the Pascal photocoagulator: a pilot study of 75 procedures. Br J Ophthalmol. 2008 Aug;92(8):1061-4