I wish someone had told me …

Regular retinal examinations are essential for identifying diabetic retinopathy and applying timely laser treatment before significant vision is lost. This is known as retinal screening and is a key part of the care of all diabetes patients. However, non-attendance at eye clinic for screening has been recognised as an independent risk factor for poor visual outcome from diabetic retinopathy.1 In 2005, we undertook a qualitative study involving focus groups and interviews in a rural and urban area to identify some of the reasons why patients fail to attend for diabetic eye examinations.2 Although our study was conducted in the United Kingdom (UK), many of the findings will be very relevant to people with diabetes wherever they live. Because the UK provides free health care for all citizens, the cost of treatment was not a barrier in this study, but it is likely to be a major barrier where patients have to pay for an eye examination and for laser treatment. We categorised the barriers into three main areas: