The Scottish grading scheme16
| Grade | Features | Location | Outcome |
| Retinopathy | |||
| No visible retinopathy (R0, M0) | No visible lesions of diabetic retinopathy | ||
| Mild background retinopathy (R1) | Microaneurysms/dot haemorrhages Hard exudates Cotton wool spots Blot haemorrhages Superficial/flame-shaped haemorrhages | Anywhere | Re-screen after 12 months |
| Observable background retinopathy (R2) | Four or more blot haemorrhages (≥Airlie House standard photograph 2a) | In one hemi-field only | Re-screen after 6 months |
| Referable background retinopathy (R3) | Four or more blot haemorrhages (≥Airlie House standard photograph 2a) | In both inferior and superior hemi-fields | |
| Venous beading (≥Airlie House standard photograph 6a) IRMA (Airlie House standard photograph 8a) | Anywhere | Refer to ophthalmology | |
| Proliferative referable retinopathy (R4) | Active new vessels Vitreous haemorrhage | Anywhere | |
| Maculopathy | |||
| Observable maculopathy (M1) | Hard exudates | >1 and ≤2 disc diameters from the centre of the fovea | Re-screen after 6 months |
| Referable maculopathy (M2) | Blot haemorrhages Hard exudates | ≤1 disc diameter from the centre of the fovea | Refer to ophthalmology |
| Gradability | |||
| Ungradable (R6) | Retina not sufficiently visible for assessment | Refer for slit-lamp examination | |
Inferior and superior hemi-fields are delineated by a line passing through the centres of the fovea and the optic disc. Designations in the Scottish grading scheme are given (R0…R6, M0…M2).
IRMA, intraretinal microvascular abnormalities.