Retinopathy is a common complication of long standing diabetes, and such patients should be screened to reduce the incidence of blindness. Effective treatment is available for diabetic retinopathy and screening can be justified on economic grounds. Many general practitioners lack the equipment or the skill to adequately examine their diabetic patients' eyes. Unless the practice is willing to buy specialised equipment and has one partner willing to learn the skills of retinal examination, the screening should either be done by local optometrists or a mobile photographic unit. In choosing between these two options, the balance is likely to change in the future, because of technical developments in the transmission, storage and retrieval of pictorial records of the retina.
Evidence is offered to show that diabetic retinopathy fulfils the four criteria for screening.
It is a significant cause of blindness. The author claims that screening is acceptable to the public, but does not have any explicit information on patient views or compliance, although is aware of the issues of accessibility, travelling time and waiting time as deterring people. It is hard to assign a monetary value to saving someone's sight. However, we cannot ignore economic factors, as health resources are finite. Would the financial argument be better supported by comparing retinopathy screening with the cost of other health interventions, or calculating the cost of preventing one case of blindness.