HSE diabetic retina screening service making a difference for expectant mothers with diabetes

Over 800 pregnant women with types 1 and 2 diabetes have been screened for eye changes caused by diabetic retinopathy by the HSE Diabetic RetinaScreen (DRS) programme. When retinopathy is caught early, through screening, treatment is effective at reducing or preventing damage to the sight.

Since January 2023, the service offers pregnant women additional, priority eye screening at a location convenient to them.

What is Diabetic retinopathy?

Diabetic retinopathy is a complication of type 1 and type 2 diabetes that affects the small blood vessels at the back of the eye, in an area called the retina. It can cause the blood vessels in the retina to leak or become blocked which impacts sight. The risk of diabetic retinopathy may increase during pregnancy, that’s why we encourage women with diabetes to take up the offer of these additional screening tests during pregnancy. Screening looks for early changes, before symptoms start.

Vicky’s story

Vicky Williams, mother to Chloe (3) and Ellie (1), has type 1 diabetes. Vicky was screened by Diabetic RetinaScreen during her pregnancy with Ellie, and shares her experience: “It’s extremely efficient, I felt I was a priority - if an appointment didn’t suit it was rescheduled straight away. That was great as I had Chloe at home and was working, so juggling all of my antenatal care was a challenge.”

The new screening initiative wasn’t available when Vicky was pregnant with Chloe, instead she travelled from her home in Celbridge, Co Kildare to Dublin for appointments. Vicky says, “This time around, I went to the centre near my home where I normally have my routine eye screening test. I know the staff and they put me at ease. I was seen quickly and at times that suited me. I got the results the next day. I’ve never been minded so closely!”

“The fear of going blind is probably my worst fear out of everything that comes with having diabetes. Anything I can do to prevent that is worth it.”

The initiative was developed in partnership with maternity units around Ireland to ensure women have a seamless route to follow-up eye testing and care if needed. At around 26 weeks, changes were seen in Vicky’s eyes and she was referred to the Royal Victoria Eye and Ear Hospital on Adelaide Road in Dublin for further tests.

“Thankfully, it wasn’t retinopathy, a blood vessel at the back of my left eye was slightly bigger due to the extra blood that flows through the body during pregnancy. I was closely monitored for the rest of the pregnancy, which was reassuring because as the baby grows the risk of retinopathy increases.”

Ellie was born in October and Vicky had her most recent eye check in February this year, when she was told everything was normal and was discharged back into annual DRS screening. The reassurance the initiative offered was important for Vicky. “I was thankful it continued after the baby was born. I knew if there were still changes in my eyes I would be in the right place. I really appreciated that.”

Diabetic RetinaScreen Clinical Director Dr David Keegan said: “We have over 130 screening locations around Ireland and we’re delighted to offer this service in them. The pregnancy screening initiative is designed to meet women’s need for additional, convenient, priority eye screening. We’re glad to say that since we introduced the service in January last year, we’ve welcomed many women with types 1 and 2 diabetes who have never had diabetic retinopathy screening before. It’s our hope that once they experience the screening test and discover how straightforward it is they choose to make it part of their diabetes management after pregnancy.

“Diabetic retina screening involves taking digital photos of the eyes. It’s painless and safe, including during pregnancy. If retinopathy is detected as a result of screening, we arrange an immediate referral for further investigation or treatment.

“Women who develop gestational diabetes do not need to attend diabetic eye screening as the condition usually resolves after their baby is born.”

Diabetic RetinaScreen Programme Manager Helen Kavanagh added: “We know screening can help preserve sight by catching any changes early. Women who have an existing diagnosis of type 1 or type 2 diabetes and who want to find out more can talk to their midwife, diabetes nurse or GP or call us on1800 45 45 55. There’s also information at hse.ie/diabeticretinascreen.”

Be aware – symptoms of diabetic retinopathy

People do not usually notice diabetic retinopathy in its early stages. Contact your GP or diabetes care team immediately if you experience any of the following*:

• gradually worsening vision
• sudden vision loss
• shapes floating in your field of vision (floaters)
• blurred or patchy vision
• eye pain or redness

*These symptoms do not mean you have diabetic retinopathy, but it is important to get them checked. Please do not wait until your next screening appointment.