Retinal screening crazy ness


#1

I have my retinal photographs taken every year. This is 26 years since diagnosis and I’ve never had any problem. Never had a diabetic complication in any way.
This time however. I got a letter from my doctor that said I have increased blood vessels in my retina but there is no leakage or bulging. That everything is fine and just repeat the test in a year.

We’ll I freak out easily so I went to an ophthalmologist who did more retinal photos and an exam with dilation. He said my retinas are normal.

My doc replied. That he has not seen my historical photos. So he can’t really know that.

So what the heck. How can this be. Either they can see a problem or not.
Not compared to last time there would be a problem. But if I skipped my exam last year there would be no problem.

I can’t seem to find an answer. I can say that for the past 2 years my control has been pretty perfect a1c at 6.0. Instead of 7 like it was for years.

Also this is the first time I checked the box that I was diagnosed more than 25 years ago. I’m just saying. I’m really confused by this. And frankly worried.


#2

I had a blip this year, the LensCrafters doc id'ed it and noted it was far away from my macula. I asked what another doc would do to it and she said "nothing" so, so far, I have blown it off. My other vision problems (dealing with bifocals/ readers) are much more concerning these days, although the blip is still there, a little "bleeder" on the retina scan.


#3

Yea funny I’m dealing with vision changes. I’m 47 and I got glasses a few years ago and I get more and more dependant on them. They all say the changes in my eyes have nothing to do with my vision but I’m still wondering and worrying. I’m too young to be blinded.


#4

As long as you have no leakage or visual disturbances, it sounds like your retinas are fine. Good job with “looking” out for yourself! No pun intended! :wink:


#5

I don't have much experience with retinal photos. They can't do them on me well due to nystagmus and the fact that I can't see well enough to easily focus on the little dot, so I've only ever had two done and the photos come out completely blurry. But from the explanation I got the first time they tried, they are looking for changes more than actual problems. So the blood vessels could look completely normal, but if there are more of them (or they are bigger, or whatever) compared with your older photos, that could indicate something that needs to be monitored.


#6

I think it’s important to note that an optometrist is not a medical doctor… If they did your initial exam and you got a second opinion from an ophthalmologist who said it is normal, I think that is grounds for a sigh of relief because the level of training of an ophthalmologist is much, much higher than that of an optometrist… I guess I am assuming the initial exam was done by an optometrist based on the way you worded your post


#7

Were either of the doctors retinologists? I would go to someone who specializes in that if not and see if the doc who took your pics can send them the images to look at. I just went to a retinologist who is very good. She is the first one to do photographs/images, as well as do the whole exam with dilation and lights, and a color test which shows if you are having problems with the retina before visual things appear in pics. When I had the pictures done I don't think I had to focus on anything, just keep my eyes open and not blink. Then she looked at the pics with me. There was a green line which I think was the retinal nerve which she said they look at and it was very smooth and looked good. As well as the larger pic of all the vessels which she said looks very good. She also noted other changes when she looked in my eyes at first, but it is nothing serious, I can't remember what she said now. I go back in 6 months. She does oxygen therapy for early treatment of retinopathy which was one of the reasons I picked her. I still have no real explanation for the blurriness since dka though, but at least it doesn't appear to be serious at this point. I did have some trouble with the purple numbers, but again she wasn't worried and I think I always had that trouble with them in the past, but it may be worse now. I also noticed a poster about medication for diabetes eye problems- I asked her if I can take anything to help prevent damage but she said I'm not at the point where I need anything. I hope you figure this out, I know how worrying it is.


#8

I'm aware the optometrist isn't a medical doctor. They do complete scans and have my historical photos so it was pretty clear. I asked her if they'd laser it or something and she didn't think they would because it was so far off to the side. I agree I will go to an ophthalmologist however it's on the list of things to do. The spring and into the summer I was over-doctored due to two odd injuries (hematoma in my leg and cyst in my armpit...) and simply was not interested in pursuing the eyes at the time. I had a doc through my old endo but didn't really like him as I think that he missed my need for bifocals so I need to find a new one.


#9

Hi meee,

Thanks for your description of what a good retinologist checks. Is there any other name that you know of for the "color test"?

Thanks again for your description!

marty1492


#10

One may be hard to find in your area but I second the suggestion of using a retinologist who specializes in treating people with diabetes. When you had the pictures taken did they inject fluorescein first?

The gadgetry my doc uses produces a 3D view of the retina - not just blood vessels. The new blood vessels that grow into the vitreous humor are apparently more prone to leakage. The 3D stuff helps with stuff like edema (swelling) which I have in one area of one eye and a wrinkle in the retina. The key strategy is monitoring change therefore the more complete the baseline data, the better.

FWIW, complications and blood glucose control are not absolutely determinant. There are people with abysmal control for long periods of time with no comorbidity. The opposite is also true. There is no "fault" involved. Good BG control is a wonderful thing, its like buying a Powerball ticket - you may not win but at least you are in the game.


#11

I agree, beechbeard. My doctor advertises his practice as specializing in Diseases of the Vitreous and Retina. I would suggest to Timothy that he start going every six months. What could it hurt, besides his pocketbook? He does not recognize that he has already had eye complications, therefore the proliferation of new capillaries, which as you know, are very fragile. Those vessels that grow into the vitreous also have a tendency to tug on the retina and can in a lot of cases cause it to become detached. Rather than break and bleed, capillaries often crack. Red blood cells are too large to fit through the crack, but blood plasma does. The retina acts like a sponge, soaking up the plasma and swells as a result. Therefore, the macular edema.
When I was a kid, I would walk around the house with my eyes closed so I would where everything was when I went blind. Ha. Here it is 55 years later and i am seeing very well, with just a couple of sessions of photo coagulation in my right and only one in my left. So, Timothy, get a grip. You are not too young to go blind, but I doubt you ever will.
Maybe someone can add to or correct my thoughts. Good luck to you, sir, and to you too, Timothy.


#12

Share your view, I knew a T1 from the prior generation who did go blind. I have only been diagnosed 42.5 years so while I shared your fear, I am a LOT younger and less experienced.

With the eyes, the sooner you know about a (potential)problem, the better. My eyes have been stable (20/20)for almost 10 years but I went through a period with laser treatments, three vitrectomies and cataracts (from the vitrectomies).

I was so phobic that they had to put me under total anesthesia for the first two vitrectomies. Even then my blood pressure was so high they thought I would stroke out.

Am not trying to compare scars (like the movie) just share some hope. I was very lucky with the skill of my retinologist (Steve Cohen in NJ).


#13

Agreed,

I've been seeing my opthamologist for as long as I've been diabetic. As soon as I showed any indication of retinopathy, which happened around 5 years ago now, he started using the more elaborate procedures to check the progression.

I started getting the angiograms using the florescent dye, and the OCR scan to check the vessels underneath the retina.

Those are just much more in depth and complete examinations that reveal a lot of subtle, and not so subtle, changes in the condition of the eye that juts can't be picked up with a visual examination after dilation, or even photographs alone.

Retinopathy is very scary and I worry about losing my sight eventually because of my own retinopathy and DME. My A1c has been under 6 for as long as I've had retinopathy but the retinopathy is stubborn. It simply has not resolved itself, even with extremely tight control. Still, I'd rather have more information about my condition than less. As my own opthomologist admits to, he's much more conservative than most and began aggressive screening ASAP. There are any number of treatments available today. Thankfully, my condition has not progressed to the poin of needing any of them, but my doctor and I stay vigilant. I take nothing for granted.


#14

I used to walk in a bar and lay 50 dollars on the counter and bet anyone there for drinks all night that I had more scars than anyone else there. I got drinks all night and would get so plastered, the bar maid would have to take me home to her house. Worked every time! lol. Except one time I met a soldier that had severe damage to his shoulder from a mortar in Vietnam. Alas, he left with the bar maid that night and I spent the night in the gutter.


#15

My Endo takes the pics , but a Ophthalmologist is the one who reads them.
The second doc was also an ophthalmologist.
I have an appointment to see a retinaologist next week. Where he will do many more tests. I want more of an education than anything else. Everyone tells me that there is nothing to do at this point anyway.


#16

Hi Marty, you're welcome :) I think it is just called the color vision test and there is also a contrast image- I think that is the images that were taken. See this video at youtube also below.

http://www.nlm.nih.gov/medlineplus/ency/article/003387.htm
http://drstevewexler.com/HollenhorstPlaqueCase.pdf
http://drstevewexler.com/Digitalretinalcamera.html

http://www.youtube.com/watch?v=pfo09jzGc5E


#17

Thanks so much for the links, meee! They were very interesting and I learned a lot!

I'm mostly concerned for my dad who has wet AMD and is getting the eye injections. The injections do seem to help.

Thanks again!

marty1492