What are the current guidelines for referring patients with diabetic retinopathy to ophthalmology for further management?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For patients with diabetic retinopathy, referral to ophthalmology for further management is guided by the findings of the NHS diabetic eye screening programme and specific clinical indicators ,.

  • Emergency Ophthalmology Review should be arranged if there is:
    • Sudden loss of vision ,.
    • Rubeosis iridis (formation of abnormal blood vessels on the anterior iris) ,.
    • Pre-retinal or vitreous haemorrhage ,.
    • Retinal detachment ,.
  • Urgent Ophthalmology Review should be arranged if there is:
    • Formation of new abnormal vessels on the retina (proliferative diabetic retinopathy) ,.
  • Following structured eye screening, a patient may be referred to an ophthalmologist, have an earlier review, or continue with routine annual review, depending on the findings ,.
  • When starting a diabetes treatment that is likely to result in a rapid, substantial drop in the person's HbA1c, the person's ophthalmologist should be notified so they can assess the eyes before treatment begins and check for changes afterwards .
  • Hospital eye services should monitor disease progression in people with moderate, severe, or very severe non-proliferative retinopathy who are not currently having treatment and have not previously had treatment . This includes considering reviews every 6 to 12 months for moderate non-proliferative diabetic retinopathy, and every 3 to 6 months for severe or very severe non-proliferative retinopathy .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.