Diabetic Retinopathy Screening

[Lottie18]

I am pretty certain you have specialist rentinophy appointments as well as the usual eye tests with opticians they are different tests or so I was informed. It's so important I would double check if you are in some doubt. The fact that so many of us agree on this should give you the confidence to challenge what DN said! Good luck

 

[bigfellasouthwest69]

Good morning,
I was diagnosed t2 about 34years ago,after losing 15 stone on a Weightwatchers programme. If only I had kept off the 15stone, but I started putting on weight and at about 18 stone became thirsty, tired and miserable, result T2. However comparing myself with others, I am managing quite well and have reached 74, eyesight checked every year, feet every six weeks by the same podiatrist for 15 years, and retinopathy check appt. with same nurse for last ten years. Weight is still a problem and has been since age 4, problems are now loss of senses of taste and smell, which has led to complete lack of appetite. Staying away from carbs is helping with sugars also changed insulin and am now on Tresiba 108 units daily and Trulicity pen every Wednesday
Due H1abc in October. Have recently moved from Somerset to Dorset, where seems to be a different NHS, but at 74 you learn to keep stum and take whatever is on offer, hence the last DRet result came from a business park and not the diabetic centre where the procedure was carried out, heigh ho.

 

[DavyPaul]

I just had my 2nd one last week.
Cardiff & Vale board, so I'm able to pop into a health centre near the office for the drops 'n' scan!
I get a letter and a txt as reminders.
I don't think opticians would normally do this.
One bonus, you don't have to pay for a regular specs eye-test.

 

[purple1505]

Hi all. Newly diagnosed T1D here, about a month ago, with a HbA1c of 124 on diagnosis. Clearly had been diabetic for months without realising. I have had most of the required health checks done to ensure I did not do any damage with such a high HbA1C for god knows how long. The last think to check are my eyes. I mentioned getting an appointment to my DSN yesterday and she said I could just arrange it with any of the local opticians boots, specsavers etc... is that accurate? I was under the impression it had to be organised through the NHS and done in specialised NHS locations?

Thanks for your help in advance!

Ian

You need a letter from your local health care for diabetes eye check. Its free as you're type 1. Both specsavers amnd boots do it but without the regular choose and book you probably get charged. It is a free service that is done every year. Maybe your nurse misunderstood you and thought you wanted a regular eye test instead of retinal photography. Ring them or explain next appointment. It for testing if you have retinopathy.

 

[Seacrow]

I get a letter once a year from the NHS eye screening service telling me which local opticians I can go to for my diabetic retinopathy check. I go to my local one, which offered retinal photographs a good two or three years before the nhs did. The ophthalmologist (lovely lady), checks my photos against last years, tells me of any changes, and sends the pictures off to be checked by the nhs opticians as well.

Why take up hospital time if I don't need to?

 

[LittleGreyCat]

Our local branch of SpecSavers will do a free eye check if you are diabetic, including retinal photography. However not with the eye drops (as far as I can remember).

My ophthalmologist always gives my eyes a very thorough going over and I am also checked by the eye screening service every year.

What doesn't seem to have been suggested so far:

1. Arrange for an immediate eye check with whoever locally will do one for free. Independent, Boots, SpecSavers, whatever.
2. Make sure that you are included in the annual screening; you may have to wait a while for this as they are generally arranged alphabetically, by birth dates, or runes and stars.

Any competent ophthalmologist should be able to detect signs of developing retinopathy, which is what you really want to know now.

The annual photography is more detailed and should be able to detect the very smallest sign of retinopathy and has the added benefit that the second and subsequent years are compared to the original to detect any very small changes which might indicate future problems.

It is 10 years since I was diagnosed so I can't remember if I was referred immediately to the retinopathy service before the cycle of annual checks started.

Whatever, the most important thing is to get a check a.s.a.p. and then start the long process of getting the bureaucracy untangled.

 

[Ian McG]

Thanks for all the replies! Checked with my GP surgery. Apparently newly diagnosed patients are automatically added to a register for the retinal screening and I should get a letter soon. So I will wait and see for now.

In the meantime I will also go to local opticians for a regular eye check up and test as I am well overdue a test and a pair of new glasses.

 

[Alison Campbell]

Ask the optician if you should wait until blood glucose is down and stable before getting new glasses.

 

[Circuspony]

Thanks for all the replies! Checked with my GP surgery. Apparently newly diagnosed patients are automatically added to a register for the retinal screening and I should get a letter soon. So I will wait and see for now.

In the meantime I will also go to local opticians for a regular eye check up and test as I am well overdue a test and a pair of new glasses.

Welcome to the club! I was diagnosed last year with hba1c of over 130. No history in the family, just a little concerned as to why my weight was dropping and I was exhausted all the time. Had blamed the thirst on the hot weather we were having....

My opticians have been brilliant and have taken photos of the back of my eye almost every time I've stepped through the door, but the one done on the NHS involves (painful) drops to open up your pupil so I guess a better shot.

Don't rush to get a new set of glasses because you may find your vision fluctuates a bit as your BG settles down.

 

[david1241]

Hello The NHS send me a letter every year telling me when to go to the surgery to have my eyes tested for retinopathy.I have background retinopathy in my left eye.so far it has not affected my eyesight.Luckily so far i can see perfectly without glasses even at 73 years old

 

[Zilsniggy]

Hi all. Newly diagnosed T1D here, about a month ago, with a HbA1c of 124 on diagnosis. Clearly had been diabetic for months without realising. I have had most of the required health checks done to ensure I did not do any damage with such a high HbA1C for god knows how long. The last think to check are my eyes. I mentioned getting an appointment to my DSN yesterday and she said I could just arrange it with any of the local opticians boots, specsavers etc... is that accurate? I was under the impression it had to be organised through the NHS and done in specialised NHS locations?

Thanks for your help in advance!

Ian

Boots etc all do the Retinal Screening, at least here in Scotland they do, as do most other opticians.

 

[Zilsniggy]

No,no,no,don't be fobbed off by the DN,the HA have a duty of care,not Specsavers,the retinopathy screening must be carried out by them,in order that regular screening and examination is made by a professional .

I think most optometrists would be a bit annoyed if you said they weren't professionals! This is not being fobbed off. Optometrists are perfectly able to check the back of the eye!

 

[Dark Horse]

I think most optometrists would be a bit annoyed if you said they weren't professionals! This is not being fobbed off. Optometrists are perfectly able to check the back of the eye!

Optometrists are professionals but they are not qualified to undertake retinopathy screening unless they have obtained specific extra qualifications in diabetic eye screening, and are working under the auspices of their local eye screening programme. In some areas of the country there are no optometrists employed by the local diabetic eye screening programme so patients should not be referred to them by their GP practice.

 

[Bluetit1802]

I think most optometrists would be a bit annoyed if you said they weren't professionals! This is not being fobbed off. Optometrists are perfectly able to check the back of the eye!

At my last screening the technician told me that normal optometrist shops do not have the advanced machinery needed for an accurate assessment, do not enhance the images fully, and do not have 2 specialists looking at them, also do not have previous images to compare with. Most do not use the drops either, which she said were important and always done unless there were special circumstances, such as previous bad reactions.

 

[Zilsniggy]

At my last screening the technician told me that normal optometrist shops do not have the advanced machinery needed for an accurate assessment, do not enhance the images fully, and do not have 2 specialists looking at them, also do not have previous images to compare with. Most do not use the drops either, which she said were important and always done unless there were special circumstances, such as previous bad reactions.

I have my screening done, sometimes by the consultant Ophthalmologist at my local hospital, who doesn't always instill drops, as I said before, it depends totally upon the3 skill of the person doing the screening. Likewise, I have lived in several places in Scotland, under different Health Trusts, and some areas DO actually have optometrists qualified to do retinal screening The screening may be forwarded to a hospital consultant for checking, in which case the results can be compared. Are we talking the photo screening or the actual scan done of the back of the eye? It's my understanding that this is not offered to everyone, but you can get one free with a good bout of diabetic maculopathy! And never done with any drops...........I seem to have one each and every time I go for injection, but then again all health trusts, while meant to operate under the official NICE guidelines, often don't due to time and staff pressures. I'm sure if I wasn't under the care of the local hospital, I wouldn't even have retinal screening done regularly! We are all subject to the dreaded Post Code Lottery in our diabetes care, some Trusts are better than others at it.

 

[Zilsniggy]

Optometrists are professionals but they are not qualified to undertake retinopathy screening unless they have obtained specific extra qualifications in diabetic eye screening, and are working under the auspices of their local eye screening programme. In some areas of the country there are no optometrists employed by the local diabetic eye screening programme so patients should not be referred to them by their GP practice.

Obviously this is different in Scotland, since only once in my 18 years of being diabetic, have I had this done in Hospital. Most of the time it is done here by a local optometrist and forwarded to the local hospital for evaluation. I haven't had to have it done recently, since I am now under the care of and Ophthalmic Consultant due to diabetic maculopathy, I now regularly undergo OCT scans. As i8ve said in response to another poster, not all Health Trusts adhere to NICE guidelines.....they are only guidelines, after all......

 

[enzina]

Here in London we all get a letter once the year telling us to go to the local clinics to have it done. I had retinopathie in the left eye but it has disappeared now. I just got the letter yesterday,.

Hope you get your test done soon!

 

[Bluetit1802]

Are we talking the photo screening or the actual scan done of the back of the eye? It's my understanding that this is not offered to everyone, but you can get one free with a good bout of diabetic maculopathy! And never done with any drops...

I was talking the normal photo screening that all diabetics are supposed to have annually.

However, earlier this year I had a floater in my left eye, which had zero effect on my eyesight. My normal high street optician referred me to the hospital eye clinic because he said their machinery was state of the art advanced and I could have an OCT scan. I attended the appointment and was given drops before the scan by the eye consultant. (Fortunately, my floater is a common vitreous detachment and requires no treatment so I was discharged.)

 

[Zilsniggy]

was talking the normal photo screening that all diabetics are supposed to have annually.

Yes, that's the one that some optometrists have done for me in the past, however no drops at Opticians. Also I have regular OCTs and never have had drops before. This is usually prior to macular injection, however, so either the mydriatic drops interfere with that process, or they may predispose to infection, if the person instilling them isn't scrupulous in their technique. Floaters are a very common occurrence after the macular injection procedure for me, since during the procedure you can actually see the fluid being injected, and there can sometimes be a minute amount of blood which shows as a dark floater. It tends to resolve over 24 hours.
I guess we are all different and have different reasons for the scan. I must ask next time why they don't use mydriatic drops. But to repeat, the 'normal' retinal screening process in this area is to just do the photo, and it is definiotely done in some places by an Optometrist. Perhaps that's one of the differences in the system between Scotland and England.

 

[Dark Horse]

Obviously this is different in Scotland, since only once in my 18 years of being diabetic, have I had this done in Hospital. Most of the time it is done here by a local optometrist and forwarded to the local hospital for evaluation. I haven't had to have it done recently, since I am now under the care of and Ophthalmic Consultant due to diabetic maculopathy, I now regularly undergo OCT scans. As i8ve said in response to another poster, not all Health Trusts adhere to NICE guidelines.....they are only guidelines, after all......

Yes, Scotland differs in some aspects - e.g. only 1 photo per eye instead of 2. The screening location varies according to the health board:-

The DRS test is done at different locations across Scotland. You might have the test at your GP surgery or optometrists.

Where you have the test will depend on your health board. They'll write to you to tell you where and when your test will be.
https://www.nhsinform.scot/healthy-...y/diabetic-retinopathy-screening-drs#overview
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If an optometrist takes photos and 'forwards' them for evaluation, the optometrist concerned should still have had extra training and be undergoing quality assurance under the auspices of the Scottish Diabetic Retinopathy Screening Collaborative, regardless of which health board they work for. http://www.ndrs-wp.scot.nhs.uk/