Significant events in the care of diabetic retinopathy and other retinal vascular disorders

Adverse events relating to the operation of the service, such as delayed assessment or treatment or loss to follow up leading to avoidable visual loss should be recorded using local reporting systems.

Significant events such as the registration of a patient as sight-impaired or severely sight-impaired due to diabetic retinopathy, vitrectomy for complications of proliferative retinopathy or the occurrence of neovascular glaucoma secondary to diabetic retinopathy are not necessarily an indication of any failure in care, but should provide an opportunity to look back at whether there are any opportunities to improve aspects of the service.

The occurrence of a foveal burn during laser photocoagulation is a significant event and should be recorded using local reporting systems.

Intravitreal injection carries a small but finite risk of bacterial endophthalmitis. This can be kept to a minimum with the use of a “clean room” and adherence to good aseptic technique. The incidence is generally 1 in 1000 or less, but increases in proportion to the number of injections required.   The College publishes guidance on the investigation and management of a cluster of cases of endophthalmitis.