Editor,—Williamson and Keating in a recent commentary in the BJO highlight the need to provide full screening for diabetic patients for retinopathy throughout the community. They presuppose that the key to diabetic retinopathy screening is efficiently obtaining images of the retina for classification.1 While the idea of digital fundus images being remotely assessed by trained personnel or even analysed by a computer automatically is attractive and may be practicable in the not so distant future, retinal photography is not the only way to organise screening for diabetic retinopathy. The other main approach to screen for diabetic retinopathy is a …