Based on the potential of eye damage from Diabetic Retinopathy am I wrong to believe that a Optho should refer a Diabetic patient to a Retinal Specialist for continued eye care when he finds signs of diabetes in a patient eyes. If not, please explain to me why not since the Optho can’t do anything about Retinopathy in the eyes. Why would any Optho wait for the progression of the disease to some level before doing a referral. To me that would be like your medical doctor waiting until you have a heart attack before referring you to a heart doctor.
I am trying to get through a recent event with Retinopathy. Thoughts Please
I am not sure what the medical protocol is, but I do agree with you. I have retinopathy and had it when I was diagnosed. The ophthalmologist took about a minute and a half to say he was referring me to a retinologist. That was late 2010. I have been to the ophthalmologist only twice since then. Once was for cataract surgery (caused by the invasive procedures to save my retinas) and the other was for a minor laser procedure a year and a half later.
I’m not sure why an ophthalmologist would not make an immediate referral. At the bare minimum you should have a specialist evaluate the situation. It may very well be early enough that you can reverse this with very tight control. I have heard of several people doing this with early detection. You may want to also check into Alpha lipoic acid (r-ala). When I told my retinologist that I was taking it he said that was a good thing and it would probably be helpful for my condition.
But it’s your freaking eyesight. I would want the most qualified person to evaluate the course of treatment for that reason.
Well Randy here is part of the real story about my recent experience that lead me to posted my message.
My Optho never ever mentioned that I had diabetic eye for 27 years even at my last visit, which was June 2016. Six months later I had an acute on-set of severe NPDR in my right eye. After my assessment by the Retinologist I am now in laser treatment for both eyes. I won’t go into details.
Now for the cute part. Of course, the Retinologist sent a copy of his report to my Optho. A few weeks later I got curious about my records and went to my Optho to get copies. When I reviewed my them .I noticed the 2014 report noted a Dot Hemorrhage and in 2015 and 2016 he noted Mild NPDR in both eye. I personally believe he changed my reports after receiving the report from the Retinologist. Now remember he never ever mentioned anything about this to me during or after my exams. In fact, after my last visit he said take care of those gorgeous eyes and I will see you next year. All I can say right now is he better hope I recover from this mess.
I hope everyone out there is not as dumb as me and totally trust your Optho. It could be hazardous to your eye health.
Randy, you mentioned tight control. Since I have been on insulin for six years now and have maintained a 5.3% AIC average. I will admitted that prior to that I averaged between 6% and 7%, which is not the greatest, but the best I could do with the pills and eventually Lantus. I am not and never have been over weight so that wasn’t an option. However, I did watch what I ate and stop all my bad habits, lol. Oh well, enough of my horror story .I will get through this unnecessary set back.
All I can give you is my experience here, in the UK, where we still have a mostly free National Health Service - I mention this to underline that most medical decisions and referrals are based purely on medical needs, not how much insurance you do or don’t have!
As soon as a patient has Type II, they are referred to diabetic retinopathy monitoring. If there are signs of retinopathy developing, the monitoring becomes 2 or 3 times a year, depending on the severity. At later stages, fluorescein angiography is now routine to help determine how much new growth exists, and lasering of the retinal periphery is a ‘normal’ next step.
A vitrectomy is normally offered if an eye is partially (or totally) blinded by haemorrhage and has not cleared within six months.
I pass on this information purely in order to show what a non-profit-based medical system in the Western hemisphere sees as usual procedure for diabetic retinopathy, and I hope that in one way or another, you will all receive the treatment you need.
A good optician or optometrist can diagnose you with retinopathy. And in the earliest stages you have tiny little bleeds (microaneurysms) which is actually quite common when you have diabetes. But just because you have early retinopathy doesn’t mean you need treatment, particular aggressive treatment that you would get from a retina specialist. If you have been diagnosed with this early form (sometimes called background retinopathy) then you would likely not be advised to treat either by an ophthalmologist or a retina specialist. Instead you would likely be advised to do your best to control your blood sugars and simply do “watchful waiting.” Frankly it sounds like @Bob_Martin’s either wasn’'t a particularly good ophthalmologist or just didn’t do his job well.
ps. An ophthalmologist should be just as qualified as a retina specialist to diagnose retinopathy and in fact may have at their disposal a better set of specialized tests that to do that diagnosis and track progression over time.
I think the real issue is having a good ophthalmologist. I became T1D in 1954 at age of 8yo. I started seeing eye doctor in the early 70’s who took pictures of my retina to keep track of changes. In the early 80’s I began to have relatively small hemorraghes. After each one I would have a series of laser treatments. This continued on and off for about 10 yrs. when I was told they had done as much laser treatment as they could do. Since then my eyes have been stable and my right eye is still 20/20 and left is about 20/40 which it was from before the time before I was T1D. I have of course lost some peripheral vision. All my MD.s were ophthamologists who did laser treatment and closely watched my diabetic retinopathy.
