guidelines. Screening criteria and risk factors that are recognized in one country do not necessarily apply in another country where available perinatal care may not be comparable. Recognizing and treating ROP in a timely fashion is critical for achieving the best visual outcome. ROP and its sequelae can cause problems throughout a patient’s life; therefore, long-term monitoring by an ophthalmologist is crucial. Since the previous edition of the Royal College of Ophthalmologists Diabetic Retinopathy Guidelines, population based digital image photographic DR screening programmes have become established throughout the United Kingdom. A number of clinical studies have expanded the understanding of the condition and management of DR. Similarly technological advances in retinal imaging especially the high definition OCT scans, wide field retinal angiography and new laser technology using multispot and micropulse abilities have widened clinical knowledge and treatment options. Medical interventions – systemic as well as ocular have revolutionised the way diabetic patients are managed in the eye clinics. The new guidelines reflect on all these changes and aim to provide up to date guidance for busy clinicians. These guidelines will be kept up to date with on line updates of major developments in the field. The aim of the guidelines is to provide evidence-based, clinical guidance for the best management of different aspects of diabetic eye disease. The foundations of the guidelines are based on evidence taken form the literature and published trials of therapies as well as consensus opinion of a representative expert panel convened by the Royal College of Ophthalmologists with an interest in this condition. The scope of the guidelines is limited to management of diabetic retinopathy with special focus on sight threatening retinopathy. It offers guidance regarding service set up to facilitate delivery of optimal clinical care for patients with retinopathy. The guidelines are prepared primarily for ophthalmologists, however they are relevant to other healthcare professionals, service providers and commissioning organisations as well as patient groups. The guidelines do not cover rare, complex, complicated or unusual cases. It is recommended that readers refer to other relevant sources of information such as summaries of product characteristics (SPCs) for pharmaceutical products as well as NICE and GMC guidance. The new guidelines incorporate established and applicable information and guidance from the previous version with revision while some chapters are extensively revised and some new chapters are added. As stated in the previous version, the guidelines are advisory and are not intended as a set of rigid rules, since individual patients require tailored treatment for their particular condition. However, it is hoped that if used appropriately, the guidelines will lead to a uniformly high standard of management of patients with diabetic retinopathy. In 2000, Ehtisham6 reported the first cases of insulin resistant diabetes (type 2) in young obese female pubertal children mainly of South Asian origin living in the UK. (Level, 2) 2. In 2002, Feltbower7 reported an increasing incidence of type 1 diabetes in South Asians in Bradford. (Level 2) 3. In 2007, Evans8 interrogated a diabetes clinical information system in Tayside, Scotland, and showed a doubling in incidence and prevalence of type 2 diabetes between 1993 and 2004, with statistically significant increasing trends of 6.3 and 6.7% per year respectively. (Level 2) 4. Gonzalez9 used the Health Improvement Network database in the UK to estimate the incidence and prevalence of type 1 and type 2 diabetes in the UK general population from 1996 to 2005 showing an increase in prevalence from 2.8% in 1996 to 4.3% in 2005. (Level 2) 5. The Office for National Statistics10 estimated that resident population of the UK was 61,792,000 in mid-2009. The UK population is projected to increase by an average annual rate of growth of 0.7 per cent, an increase of 4.3 million by 2018. The Office for National Statistics estimated11 that resident population of England was 51,456,400 in 2008. With a 0.7% increase per year, the total population in England in 2010 is estimated to be 52,176,789. From DH screening figures12 we know that practices have identified 2,379,792 people with diabetes over the age of 12 years in England in 2010. A survey13 conducted by the Royal College of Paediatricians between January and March 2009 identified approximately 9296 children in England with diabetes under the age of 12 years. Hence the total number of people with diabetes in 2010 in England is estimated to be 2,389,088. (Level 2) The percentage of known people with diabetes in England in 2010 is, therefore, estimated to be 4.58% of the total population. In the Diabetes UK report ‘Diabetes in the UK 2010: Key statistics on diabetes’, it is quoted that in 2009, the prevalence of diabetes in the adult population across the UK was 5.1% based on a number of people with diabetes of 2,213,138. 6. The United Kingdom Asian Diabetes Study14(UKADS) was a cluster randomized controlled trial designed to evaluate the benefits of an enhanced diabetes care package for people of south Asian ethnicity with type 2 diabetes in Coventry and Birmingham, U.K. In a sub study of UKADS15 , comprising a cross-sectional prevalence survey using retinopathy screening data from 10 general practices in the Foleshill area of Coventry in central England, the 15 grade of retinopathy was compared between 421 patients of south Asian ethnicity and 614 white European patients. Patients of south Asian ethnicity had a significantly higher prevalence