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Diabetic Retinopathy Screening
Click here to download the Diabetic
Retinopathy Screening form
Click here
to download the Patient Consent Form
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The Diabetic Retinopathy Registry was initiated by Dr Deon Doubell, from the Eye
and Laser Institute, 205 Cape Road Port Elizabeth, telephone +2741 3748938. The
registry collects information from 2 sources.
Source 1
The healthcare practitioner conducting the annual diabetic retinopathy screening
examination completes part A of the form - Click here to download the form.
Source 2
Patients with a risk factor in excess of 10 are referred to an Ophthalmologist
by the examining healthcare practitioner. The Ophthalmologist will conduct an
examination, then enter the information into the Diabetic Retinopathy Registry
which can be found in the secure members only section of this website. Click
Patient consent" click here to download PDF the patient
consent form "This must be completed before a patient's information is captured
into the registry. The practitioner Is required to keep the patient consent form
in the patient's file.
Additional information - contact Deon Doubell - 041 374 938
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