Annual retinal photography is not an option in India

skills are maximised through experience and that cost efficiency is increased.The cost of identifying each true case of retinopathy needing treatment has been shown to fall as throughput increases.3Patients are recalled to the screening clinics through use of a computerised appointment system and a centralised register.Diabetes care requires several health care processes, as well as screening of the eyes, to be performed regularly in a large number of people.The Clinical Standards Advisory Group has recommended that, for this to be organised efficiently and completely, health districts should develop and maintain registers of all people with diabetes in the locality to span the boundaries of the provision of primary and secondary care.4