This guideline last updated 07/05/2022 9:59:56

COVID-19 Emergency Response

• Retinal Screening in Scotland has paused
• Treatment priority is for symptomatic (and visual acuity worse than 6/12) second, or only eyes.
  • Check with your Board whether first eyes are still being treated
• Untreated eyes will still preserve navigational vision
• Only refer patients to ophthalmology who are willing to receive monthly intravitreal injections
  • Use optical coherence tomography in preference to slit lamp examination in patients who wish to proceed to injection therapy if oedema found

Differential diagnosis

• Retinal vein occlusion
• Age-related macular degeneration
• Central serous retinopathy
• Idiopathic macular telangiectasia

Possible management by Optometrist

Treatment

• None

Advice

• Observation by diabetes eye screening, if asymptomatic
• Routine referral, if symptomatic, to ophthalmology, with images
• Advise the importance of regular attendance at diabetes eye screening to preserve sight
• Refer patient to General Practice to facilitate optimisation of blood pressure and glycaemic control

Management Category

• Refer to Diabetes Eye Screening Service if asymptomatic
• Refer to Ophthalmology if symptomatic

Possible management by Ophthalmologist

• Intravitreal anti-vascular endothelial growth factor therapy
• Intravitreal steroid therapy
• Macular laser