Changes to My Eyes

[ScottyD]

Hi All,

Been a while since I've posted but visit now and then.

I have a question/concern.

I went for my yearly retinopathy check a couple of weeks ago. I got the letter through today with the result:

"The results of your eye screening show that you have some slight early diabetic changes to your eye(s). These changes do not require any treatment at the present time and there is no cause for concern as there is no immediate risk to your vision. An invitation will be sent to you next year for your annual eye screening appointment"

It got me worried to say the least. I've been diabetic since June last year and all my A1cs (I go for my bloods every 3 months due to my occupation) have all been nicely under 6.5%. I know that it therefore doesn't prevent you from issues but it should greatly reduce them...I've been as low as 5.7%.

Have I actually got retinopathy on a very small level or is it just changes due to my bloods being naturally perfect pre-diabetes to now having high sugars occasionally? Providing my controls stays steady now, every year after that, change will be next to nothing?

Any thoughts would be appreciated. I have dropped a message to my diabetic nurse, just waiting to hear back from them.

Thanks!

 

[Miss90]

I have had the same result for about the last 5 years - mild background retinopathy. Provided you look after yourself there is no great cause for concern. My doctor told me once that mild background retinopathy can sometimes repair itself if your control is good!

 

[Juicyj]

Hey @ScottyD - good to hear from you again.

Slight changes may reflect the time you went undiagnosed, however since your control is good I wouldn't worry too much about this at all. I was diagnosed 5 years ago, the following year I had a letter stating I had background retinopathy which sent me into a mild panic, however after becoming well controlled and stabilising my blood glucose levels the following year it came back as normal, and since then no issues. @noblehead is more clued up than me on diabetes and vision so he should hopefully respond further to allay your concerns Scotty

 

[noblehead]

The wording of the letter is encouraging @ScottyD , the fact that they say there's no cause for concern and they don't want to see you until next year.

If they are referring to background retinopathy then it can in some cases it can clear on it's own as @Miss90 & @Juicyj have mentioned, so just keep doing what you doing and keep your bg levels under control as well as your bp and cholesterol levels, you may have seen this website before but it has a wealth of information and advice on diabetes related eye conditions:

http://www.diabeticretinopathy.org.uk/back_diabetic_retinopathy.html

Good luck.

 

[ScottyD]

Thanks for the replies @Miss90 , @Juicyj and @noblehead .

I guess with my good control I'll just keep doing what I'm doing and it shouldn't get worse and if indeed it's a hang over from my pre-diagnosis last year, all could be deemed normal next year?

I attended my fourth and final insulin pump group at the beginning of July and one of the members had retinopathy and had to get his eyes screened every 3 or 6 months, can't quite remember. With me still on the standard 12 month check, it's nothing to worry about and it could just be the usual hang over from high sugars pre-diagnosis...

Thanks again!

 

[noblehead]

I attended for fourth and final insulin pump group at the beginning of July and one of the member had retinopathy and had to get his eyes screened every 3 or 6 months, can't quite remember.

If background retinopathy has been confirmed and they've been referred to a Ophthalmology Clinic then they may request that the person is seen every 3-6 months, especially if the condition progresses to the pre-proliferative/proliferative stages.

Good luck with the pump btw, you won't regret it

 

[ScottyD]

If background retinopathy has been confirmed and they've been referred to a Ophthalmology Clinic then they may request that the person is seen every 3-6 months, especially if the condition progresses to the pre-proliferative/proliferative stages.

Good luck with the pump btw, you won't regret it

I wasn't quite sure of the level of Retinopathy if I'm honest. So since they don't want to see for another 12 months, is it reasonable to say I haven't got Retinopathy? Or is any changes to your eyes, big, small or tiny still deemed as Retinopathy?

 

[fletchweb]

Hi All,

I went for my yearly retinopathy check a couple of weeks ago. I got the letter through today with the result:

"The results of your eye screening show that you have some slight early diabetic changes to your eye(s). These changes do not require any treatment at the present time
Thanks!

Something similar happened to me about 20 years ago - but my eyes are still good and so is my visual acuity. Some years are better than others when I see the ophthalmologist but considering the number of years I've been living with type 1 I consider myself lucky.

Probably just a routine letter with a little bit of angst thrown in for good measure. The health industry tends to do that. I wouldn;t worry...

 

[Dark Horse]

As I have said previously:-
Please bear in mind that no screening method can ever be 100% accurate and there will always be false positives and false negatives. A good screening service could have as many as 5% of people without sight-threatening retinopathy mis-identified as having it. Screening results should never be considered as a 'diagnosis' but an indication of whether or not further tests are needed by an ophthalmologist.

As the aim of diabetic eye screening is to detect sight-threatening diabetic retinopathy. The standards for minimising false positives do not apply to the detection of background retinopathy and the percentage of people falsely identified as having BDR is likely to be much higher. There are a number of features that can be confused with diabetic retinopathy such as areas of pigment, unusual appearance of vessels or retinal haemorrhages occurring for another reason which is not diabetes. The more screenings someone has, the more possible it is to identify confounders for diabetic retinopathy so someone can go from 'background retinopathy' to 'no diabetic retinopathy' even if there has been no visible change.

Background retinopathy generally takes at least 5 years to develop. In people with type 1, where onset of diabetes is identified very rapidly, it is very unlikely for background retinopathy to be present at the first yearly screening. (This is unlike type 2 diabetes where people may have had diabetes for several years before they are diagnosed so a good proportion of them have diabetic retinopathy at their first screening.) If you are genuinely type 1, I would treat your result with some skepticism.

In any case, background retinopathy does not affect your sight and the risk of progression to sight-threatening retinopathy is much reduced by maintaining good diabetic control.

Note that 'background retinopathy' is what is being referred to when your letter says 'slight early diabetic changes in your eyes'.

There is information about the types of retinopathy here:- http://www.diabeticretinopathy.org.uk/Information_for_patients.html#types

 

[noblehead]

I wasn't quite sure of the level of Retinopathy if I'm honest. So since they don't want to see for another 12 months, is it reasonable to say I haven't got Retinopathy? Or is any changes to your eyes, big, small or tiny still deemed as Retinopathy?

Hi again @ScottyD

I wouldn't like to second-guess what the retinal screening people have found, but as they say there's no cause for concern you shouldn't worry too much (but appreciate the nature of your work won't stop you from doing that).

Here's what I would do, as your due to start on a pump you'll know doubt have to see your diabetes consultant before or after the start date, when you do discuss things with them as they should be able to upload the results of your retinal eye screening appointment. Best wishes and hope all is well.

 

[ScottyD]

Hi All, thanks for the replies!

I got an email from my treating consultant: There is a tiny dot on the periphery of the right retina classed as a microaneurysm and hence the background retinopathy grading. She said my eyes was 20/20 when reading the letters chart before the photographs - I was reading the very bottom line on the chart with both eyes so I guess my visual acuity isn't hampered by this? My consultant said the rest of the retina looks completely fine and hence the screening will just be the usual 12 months as sometimes I can go away. It's just the nature of my job stresses me out!
I went for my yearly pilots medical where blood pressure was in limits, height/weight was all good, non-smoker and drink alcohol very rarely. Hopefully it subsides as I'm doing all I can and my diabetes control is as best as I can get it!

 

[himtoo]

they will monitor that spot and will treat it ( if it needs treating )
for the foreseeable future try not to worry !!!!!

 

[Scott-C]

I got a letter worded exactly the same way a couple of years ago, but the next one came back clear. The consultant said that sometimes it'll just heal itself it. And sometimes the person who has interpreted the image has been over cautious/enthusiastic and it can sometimes be a false positive.

 

[TheBigNewt]

I wasn't quite sure of the level of Retinopathy if I'm honest. So since they don't want to see for another 12 months, is it reasonable to say I haven't got Retinopathy? Or is any changes to your eyes, big, small or tiny still deemed as Retinopathy?

I think it's safe to say you have no retinopathy, nor is it likely at all considering how short a time you've had diabetes. I haven't had an eye exam in about 5 years, guess it's time I made an appointment eh? I still use the same glasses and see just fine though!

 

[Dark Horse]

I think it's safe to say you have no retinopathy, nor is it likely at all considering how short a time you've had diabetes. I haven't had an eye exam in about 5 years, guess it's time I made an appointment eh? I still use the same glasses and see just fine though!

The aim of diabetic eye screening is to detect sight-threatening retinopathy BEFORE any symptoms develop as this is when treatement is most effective. Treatment may stop vision getting worse but doesn't usually improve it. It's therefore important to get your eyes checked annually (or perhaps every 2 years if no background retinopathy has been detected) even if your eyesight is fine.

 

[ScottyD]

Thanks for the replies everyone.

As well as concerned, I was a little confused - I have really good control and other factors like blood pressure & cholesterol are all within healthy ranges! I understand that you can have all of the above under control and years down the line get some forms of retinopathy or other complications but not just one year after diagnosis with all the above parameters in check.

Hopefully it disappears!

 

[ScottyD]

Hi all.

Sorry to bring this thread back. I just thought it'd benefit other people should it happen to them...

Having got my eyes screened back in July for my yearly retinopathy check, a microanersym was found on the outer edge of my retina in my right eye. I then received a letter from the NHS saying I had 'slight diabetic changed'. Naturally, only a year into being T1, this had me freaking out and hence this post.

I got my eyes checked again at the end of September whilst getting my 3 monthy A1c and other bloods done for my pilots medical. The person doing the photographs was a grader and he graded them informally, there and then. All completely clear.

I mentioned this to the consultant when going for my pilots medical check up to which they said you can bounce back and forth between background retinopathy and no retinopathy and it's of no major concern at all whilst maintaining good blood glucose control and good blood pressure. As said above by you guys! Just nice to hear it from the doctors mouth!