Special attention should be paid to the needs of the visually impaired and the provision of wheelchair access since eye and foot problems are the commonest complications of diabetes. There are many optometrists who are currently screening for diabetic retinopathy. It is likely that optometrists would be the major group in a screening programme using indirect slit lamp retinal biomicroscopy. Other personnel, notably ophthalmic medical practitioners, could also perform ophthalmoscopic screening. Personnel Standards Standards are required for the assurance of quality.
Programmes currently vary on whether refraction is routinely performed.
A national policy is required. There is currently variation on the use of tonometry. There may be an association between diabetes and glaucoma. Guidelines specifically for this programme are needed. Current opinion supports routine pupil dilation 7 .