Diabetic retinopathy is the leading and preventable cause of visual impairment and blindness in the WHO European Region. It occurs in about a third of people with diabetes and its devastating effects on vision can be prevented with early detection and treatment with screening.

Visual impairment and blindness have serious economic consequences in terms of use
health and social care resources and the impact on economic productivity. Although many countries in the WHO European Region have some form of vision testing for people with diabetes, they are often not adequately provided or organized systematically as a screening pathway.

The focus of this guide is to show how countries can improve their approach to diabetic retinopathy screening by understanding how to design an effective systematic screening programme.

The guide moves on to describe the steps of the screening pathway: identifying the population eligible for screening; invitation and information; testing; referral of screen positives and reporting of screen-negative results; diagnosis; intervention, treatment and follow-up; and reporting of outcomes. It shows that for diabetic retinopathy screening to be most effective, a screening pathway encompassing all these steps should be in place.