I've had an eye exam from real ophthalmologists every year since dx. I've also had superb control with A1Cs between 4.9 and 5.5 the entire time. The ophthalmologists have always said my eyes look fine. My vision has has always been 20/20.
Today I saw a local optometrist, for the sake of convenience, instead of traveling considerable distance to see an ophthalmologist. He did an exam and retina photographs. He noted micro aneurisms in my right eye, which he defined as "mild non proliferative diabetic neuropathy"
This comes as a very large surprise to me because of my relatively recent diagnosis (2012) and my superbly tight control. He said that he's really not all that worried about it at this point but it does warrant keeping an eye on. My vision was 20/20. The optometrist was concerned because I was there for a required license exam and he thought it could cause complications with my professional qualifications... I'm not that worried about that aspect because my vision was 20/20 still and as long as my vision isn't affected I don't think there will be any headaches in that department.
He said it was so minor that he wouldn't be surprised at all if it was not visible on my next exam. His only recommendation was to continue getting eye exams every 12 months.
Is it suspect that the ophthalmologists said everything is fine every time and an optometrist says otherwise? Any of you have comparable eye exams? Any thoughts?
If he took the photos and the damage is there,then it's hard to deny. Sorry to hear you have some eye damage but the fact is your a diabetic and you can fall anywhere on the curve when it comes to complications...just because a diabetic has good BG control does not excuse them from the possibility of some damage, and on the other hand poor control and a long life of high BG does not guarantee complications.
Your young and it could just be a coincidence, the same thing can happen by physical straining...like lifting weight!
I suppose my main concern is that it doesn’t speak highly to my overall hardiness with diabetes if this can happen with essentially perfect control. I guess I’ll just have to hope that it’ll settle out and not be visible on next exam-- he said that wouldn’t surprise him at all.
He also was the only exam to use the retina scan photos… The ophthalmologists just used the scope— he said he wasn’t sure if he’d have noticed without the photos… So who knows maybe TMI isn’t alwas a good thing
Sam - You probably experienced some hyperglycemia for some period before your actual diagnosis. I wouldn't be too worried about this finding but I would recommend that you see an opthamologist when convenient.
It may help to relax some of your understandable concern. Your focus on tight BG control is your best defense to delay any progression of retinopathy. Please keep us updated.
Yeah my BG was off the charts when it was first diagnosed... we'll never know how long it was elevated before that.. long enough to have an A1C of 11+ is all I know
I wouldn't trust my vision to either a regular opthalmologist or an optometrist. I recommend finding a good opthalmologist who specializes in the retina and other related issues who can evaluate the situation.
The studies of retinopathy risk clearly show that the risk rises with increased blood sugars. But it also shows that there is still an increased risk for diabetics compared with non-diabetics even with perfect blood sugars. There just seems to be something about having diabetes.
ps. And there are variouos causes of microaneurysms including hypertension (which could also be cause if you do things like heavy lifting)
My sympathies. It's worth bearing in mind that this sounds very mild for now. And I would want to get a second opinion from an opthalmologist who specializes in retinal disease. And keep in mind that while diabetes can raise the risks, non-diabetics get these conditions, too.
Finally, optometrists are often too lazy to test beyond 20/20, but I suspect your vision is significantly better. The theoretical limit of human vision is 20/8, 20/20 is sort of an arbitrary standard that defines what a normal person should be able to achieve. At my most recently exam, I measured 20/15 with both eyes, and I was close to getting 20/10. Growing up I was always the kid with crazy acute vision.
I'd been "clean" for a while then a couple of years ago, the doc at LensCrafters,an optometrist, found a bleeder, just one. I was like "eek" but also asked "do you know what an ophthalmologist would do for that?" and she said "nothing" so I figured I'd just wait a year and do the specialist later. Next year, I went to the ophthalmologist who found 3 "bleeders" and said "if there were like 100, we'd consider doing something, lasering them but for now, we wait and monitor it..." so that was about it. I'm older (47) and have had T1 longer but I figured it was inevitable. So now we wait.
I was hoping you’d chime in, I remember when you first posted about your LensCrafters appt. sounded like a similar scenario to my own. Wait and see. Band hope it doesn’t cause more headaches with my job license. Doubtful it will since vision is still fine but I am sure the powers that be will love to harass me about it and make me jump through a million hoops.
I out of curiosity were both your exams using the retina scan photos? I’m wondering I this had been there for years but the expert eyes disregarded it as insignificant wheras the wavelength filtered camera makes it look more alarming
Sometimes dropping your A1c fast can cause some eye damage also, you could be seeing the tail end of things getting better...your next visit could be perfect.
I would recommend that you stick with a doctor that has modern equipment and can take photos of your eyes every year and look back to see if there is some type of progression. You have 20/20 vision your fine...my brother is a pilot, 69 years old and is insulin dependent...he is required to see his Endo and flight doctor every three months, they can't find a reason to suspend him so he just keeps flying.
I had photos both times, and had been to LensCrafters before. I asked the Ophthalmologist if they wanted the LC pics and they said "no" so now I'm waiting for their second shot. I think the continuous eye follow-ups without actually doing anything may be sort of a regular feature of opthalmological medicine from cases at work but I'm sort of like "what's it going to be this year? 4, 5, 12, 36? Eeek!"
I've never had anyone photograph my retinas. I've only gotten exams from opthalmologists, and they universally seem to prefer just looking through their scopes, and at least so far, haven't found anything interesting on which to remark. I find the idea that optometrists use technology that helps them more easily detect retinal disease than opthalmologists a bit odd, for obvious reasons.
That same thought process is certainly present in my mind. The ophthalmologist I had been going to see at Oregon Health Sciences University is supposedly one of the best in the northwest. (I travel over 1000 miles to see him, coincidentally-- I do business in that area from time to time). He's probably 65 years old, and old-school. Looks through his scope and says "you most certainly don't have any diabetic retinopathy" almost as if its a ridiculous question.
The optometrist is probably 30, and is right down the road (in the same building as the CARQUEST)... had all the high tech gadgets.... Came in and started lecturing me about how diabetes control is important-- then he looked at my chart and saw an a1c of 5.3 and that I rarely have BG above 120 and said, hmm, well these may disappear on their own... I wouldn't have expected to see true diabetic retinopathy with your history.
The photos he showed definitely did have two pin-point dark spots on them. Would a veteran ophthalmologist like my usual have even batted an eye at them, I don't know.
I spent a fair bit of time comparing retina pictures on the internet. I'm not an expert, but my belief at this point is that the optometrist mischaracterized vitreous floaters (which I've had for years, and had been noted by the ophthalmologist, and are insignificant) as micro aneurysms related to diabetic retinopathy. Of course I'll test my theory with an ophthalmologist.
I wondered about this. I've had some vitreous detachment over the years, which isn't a big deal, though a bit odd given that I'm young-ish and not a boxer or football player or headbanger. Sounds like you may be similar.
I feel for you.!!! Although I have been Type 1 for over 26 years,Tight control esp lately (6.0) I have never had anything come up with my eye exams or retinal photos until last year.
I got a note that said I have increased vascular growth in one eye, although the report said it was was no big deal and I could wait until next year.
I get freaky about that stuff so I went in to my ophthalmologist and he said he could see nothing in my eyes but the increased growth( compared to last years photo) of blood vessels are worry some because new ones tend to bleed more than old ones.
This year the report came back as NORMAL no comments.
SO you can not ignore the human factors in this, Get a second opinion. I was told that any minor leakage should be treated immediately so it will not lead to retinopathy.If you wait for major leakage,you may have already lost some retina.
It may be worth the drive to see a new doc just to put your mind at rest
