Grading diabetic retinopathy (DR) using the Scottish grading protocol.

Although traditionally the features of DR have been identified through direct ophthalmoscopy or slit lamp biomicroscopy, digital photography is more sensitive than direct ophthalmoscopy and is comparable to slit lamp examination by a trained observer.1A digital fundus camera has the following advantages:Fast and convenient imaging of the retina by a photographerStorage, archiving, and transmission of the imagesUse of the images for quality assurance (that is, having them checked by another person) to ensure that no cases of retinopathy go undetectedAbility to enhance images – magnification, red-free, enhanced contrast, etc.When using the Scottish Grading Protocol2, just one retinal photograph is taken, which is centred on the fovea. The field must extend at least 2 disc diameters (DD) temporal to the fovea and 1DD nasal to the disc for adequate visualisation.