Second eye test when first is fine? 90 yo T2

EllieM

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My 90 year old T2 (for a decade) dad, hba1c low 50s when unmedicated (low carbing) had his annual diabetic eye test a month ago. He was told that all was well. He's now received a new appointment at a different hospital for a second "different" eye test. He's already phoned them once to be told it's a different test, but is going to try again. (He's not keen on the hospital because he has mobility issues and it requires a lot of walking, and he has been heavily covid shielding so would prefer not to visit hospital at all if it can be put off till after a covid vaccine).

So, any suggestions on what could be going on here? Why a second test if the first is fine? Testing for glaucoma?
 

DCUKMod

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My 90 year old T2 (for a decade) dad, hba1c low 50s when unmedicated (low carbing) had his annual diabetic eye test a month ago. He was told that all was well. He's now received a new appointment at a different hospital for a second "different" eye test. He's already phoned them once to be told it's a different test, but is going to try again. (He's not keen on the hospital because he has mobility issues and it requires a lot of walking, and he has been heavily covid shielding so would prefer not to visit hospital at all if it can be put off till after a covid vaccine).

So, any suggestions on what could be going on here? Why a second test if the first is fine? Testing for glaucoma?

I can't throw any light on your Dad's situation at all, Ellie, but as I understand it, the diabetes screening programme only looks for retinopathy. Obviously, if anything else materially concerning came to light, they would have a moral responsibility to highlight it, but if you Dad has had the all-clear, I'm be surprised and disappointed if that was the case.

Trying again seems to make sense, and maybe your Dad can raise his specific concerns when he does so.

Alternatively, maybe his GP might be able to help oil the wheels. They should be open for business, although perhaps not on a F2F basis in the first instance.

On an aside, my OH has been having glaucoma monitoring for as long as I have known him, due to his father living with the condition for many years of his life. That monitoring is done by his optician, who seems to spend quite a bit of time on it.

If your Dad gets nowhere with the clinic or his GP (which would be frustrating), he could always approach his Optician to see if they might be able to have a really good look at his eyes. If he is shielding, then an early appointment might be best to avoid folks - although if your Dad has mobility issues, it might take him a little while to get going in the morning.

Well done to your Dad for keeping himself in decent shape, and hopefully he'll get somewhere with his puzzle. It's a worry. Our sight is so precious to mess around with.
 
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Dark Horse

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My 90 year old T2 (for a decade) dad, hba1c low 50s when unmedicated (low carbing) had his annual diabetic eye test a month ago. He was told that all was well. He's now received a new appointment at a different hospital for a second "different" eye test. He's already phoned them once to be told it's a different test, but is going to try again. (He's not keen on the hospital because he has mobility issues and it requires a lot of walking, and he has been heavily covid shielding so would prefer not to visit hospital at all if it can be put off till after a covid vaccine).

So, any suggestions on what could be going on here? Why a second test if the first is fine? Testing for glaucoma?
It's possible that the diabetic eye screening found no problems with diabetic retinopathy (hence the 'all is well' results) but spotted something non-diabetic (such as glaucomatous changes) and informed the GP. If so, the GP would review the patient notes and make a decision whether a referral was necessary. Your dad needs to ask his GP why he has been referred to hospital.
 
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EllieM

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It's possible that the diabetic eye screening found no problems with diabetic retinopathy (hence the 'all is well' results) but spotted something non-diabetic (such as glaucomatous changes) and informed the GP. If so, the GP would review the patient notes and make a decision whether a referral was necessary. Your dad needs to ask his GP why he has been referred to hospital.

Well, he's tried calling the surgery, and no one could tell him anything, but they did give him a number for the hospital, so he's going to try that on Monday. I'm not convinced that it's not a diabetic issue, TBH, because depending on who took the photoes they don't always tell you at the time, and maybe the photographer just made some reassuring noises? Will update here when we eventually even get to the bottom of it.
 

Dark Horse

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Well, he's tried calling the surgery, and no one could tell him anything, but they did give him a number for the hospital, so he's going to try that on Monday. I'm not convinced that it's not a diabetic issue, TBH, because depending on who took the photoes they don't always tell you at the time, and maybe the photographer just made some reassuring noises? Will update here when we eventually even get to the bottom of it.
Ah, when you said the result was 'all is well' I assumed you were talking about a results letter. Photographers aren't allowed to comment on the screening results at the time of photography because the camera doesn't show the photos in enough detail and also for quality control reasons. If it was a verbal 'all is well' it might just mean that the photographer was saying that they had managed to take clear photos.

If your father hasn't received an actual results letter from the diabetic eye screening he should phone them and ask for a duplicate to be sent out. However, his GP should have had a copy of the results and if the diabetic eye screening programme had made the referral the GP should have a notification of this in the GP report.
 

EllieM

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However, his GP should have had a copy of the results and if the diabetic eye screening programme had made the referral the GP should have a notification of this in the GP report.

That's interesting. His GP has told him zilch other than giving him an additional phone number for the eye hospital....
 

DCUKMod

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That's interesting. His GP has told him zilch other than giving him an additional phone number for the eye hospital....

Ellie - I echo @Dark Horse 's suggestion of getting a copy of (or looking online at) the GP letter. Where are is anything to report, the GP letter carries more detail that that which is sent to the patient, although it is still very much in summary form.

If your father has access to his full medical records, he should be able to see incoming clinic letters. He can also nominate another person to access his records, although I do appreciate that that isn't for everyone.
 
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Dark Horse

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One thing that sometimes happens, particularly with elderly patients, is that some degree of cataract makes photographic images unassessable. The patient would then be referred to an SLB (slit-lamp biomicroscopy) clinic for a different test where the eye is examined with a lens and a bright light. However, when these sort of referrals are made a) the patient should get a results letter from the original screening explaining this and b) the GP report should also state that the image(s) were unassessable and the patient has been referred to SLB. Try and get hold of the original patient results letter.