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Before starting Rybelsus , your GP or diabetes specialist should: Review your history of diabetic retinopathy Ensure you are enrolled in the NHS Diabetic Eye Screening Programme Check when your last retinal screening occurred Consider ophthalmology referral if you have known moderate to severe retinopathy During treatment , the following monitoring approach is recommended: Continue annual diabetic eye screening as standard for all patients with diabetes More frequent ophthalmology review may be appropriate for patients with pre-existing retinopathy, with intervals determined by the NHS Diabetic Eye Screening Programme grading and ophthalmology pathways Monitor the rate of HbA1c reduction gradual improvement over 612 months is preferable to very rapid decreases Maintain regular diabetes review appointments to assess overall glycaemic control and adjust treatment as needed Patients should be proactive in attending screening appointments and should not assume that absence of symptoms means absence of retinopathy