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Eye testing by NW Eye Testing Service, is it a scam?

@Mike Solomons doesn't your wife have a normal sight test at an opticians? I go for an annual test at Specsavers, they are extremely thorough and include field tests, eye pressure tests and slit lamp examination with eye drops if necessary. They take retinal photographs to spot any abnormality but for the specialised high resolution needed for early detection of retinopathy I also have to go to a test with the retinopathy screening service at my local hospital.
 
Boo1979 said:
The research data is that the national retinal screening programme ( which is the same everywhere) has stopped many people going blind. I see that you only joined today - presumably just to post this content?
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I joined The British Diabetic Association, now Diabetes UK in 1985 when my diabetes was diagnosed. I joined this forum today as I am still furious at the way, as I see it, people with diabetes are being cheated. You can make of it what you will that otherwise nothing in my experience of diabetes related care has been unsatisfactory to this degree. I hope that my post and a few letters that I have written will result in an improvement in standards. I am also hoping that my wife can have her eyes properly checked.

However, the thought that most people are unaware of the deficiencies of the service is very bad, the service must be improved or closed.
 
Mr_Pot said:
As I said above, take her to and optician.
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You have missed the point, I took my wife to a specialised diabetic eye checkup and found the inadequate shambles described at the top of this thread. My wife does see an optician, but the optician doesn't match the eye check standards that I routinely have, also arranged by the NHS. But why should you and I be content with the service we obtain whilst "the others" get shovelled into a second rate seemingly cut price checking scheme. Everyone should be properly checked and advised.
 
Here in Bangkok my diabetes doctor schedules me an eye test once a year with a specialist eye doctor Always with the Eye Drops Which Sting if during my quarterly visit for blood tests I have the opportunity to raise any eye problems and can see the eye doctor immediately.

Difference between NHS and Thai service one is alleged to be free but paid for by Workers and employers by TAXATION .

the other paid by me as follows DOCTORS FEE 12 Pounds Blood TEST 25.Pounds Eye TEST 25 Pounds

All Medication Extra so you think before you complain about the NHS I AM NOT SAYING IT IS PERFECT Far from it
but constant criticism is not helpful unless it is constructive and the real problem is funding Staffing and traing all of which cost money which ultimately come from Workers through TAXATION oh and employers Solution ?
 

Mike - I'm interested to understand if you have any eye issues, or if your own eyes are in good shape?
 


It is important to know that the "service" about which I complain is run by a private company paid to carry out these tests for the NHS. I very much doubt that those who commissioned the work expected these standards, which is why I have asked them to investigate. Ultimately, the NHS can only become aware of deficiencies if they are informed. Meanwhile, I'm warning readers of this forum.
 
DCUKMod said:
Mike - I'm interested to understand if you have any eye issues, or if your own eyes are in good shape?
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I have eye difficulties that are closely monitored by an outreach clinic run by Moorfields. Currently my sight is good and I have, for example, no difficulty driving at 130 kilometres per hour in France in the dark, (it's legal there!), but there are problems. However, to further explain my annoyance at the tests my wife had, her sight is much worse than mine yet Health Intelligence Ltd, the company that runs the clinic where her eyes were checked claims that nothing significant is wrong.
 
Do you release that most GPs services are run by private companies and have been since the NHS started...... Therefore why do you object to private compaines running NHS services?
 
You presumably get seen by a specialist eye clinic because you have a diagnosed eye condition ( not retinopathy?) requiring specialist intervention and monitoring. Your wife is attending a screening service because she is at risk of diabetic retinopathy which is all they are screening for. An optician / optometrist or your wifes GP is the first point of call for other eye health conditions - they are the gatekeepers for and accepted referral routes to specialist eye care services
 
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I enjoy the reassurance I get from my annual retinopathy photograph - they have photographs now going back years and these can be compared for signs of change.

I make sure I'm up to date with regular sight tests with my optician, too.

So far, so good! No problems. At my local hospital it's called a 'retinopathy screening' - literally you just pitch up, get the stingggggy drops put in, wait 20 minutes, FLASH, job done.

My eyes are also looked at as part of my diabetes annual review.

Perhaps it varies geographically.

 
You say you took your wife for this eye test was it a routine appointment for a retinal scan that all diabetics have. My husband and I both T2 have a annual retinal scans at a NHS medical centre in our area and the same is done as you have described as your wife having that is the standard retinal test we all have. The majority of other eye problems are diagnosed at a regular opticians eye tests when again if a problem was found they would refer the person to a specialist eye clinic
 
Some facts about the Diabetic Eye Screening Programme:-
  • It is a nation-wide service set up to reduce the numbers of new cases of blindness due to diabetic retinopathy
  • It is a screening service so is aimed at people who have no symptoms of diabetic retinopathy
  • The first part of the screening test consists of reading a simple eye chart to check how well the retina is functioning. This may involve the use of a pin-hole if the patient hasn't got up-to-date distance glasses with them.
  • The second part of the screening test consists of taking two overlapping photos of the retina through a dilated pupil. These are then examined using specialist software and graded.
  • The photos are may be taken by a technician or optometrist but will then be graded by specialist graders (which may include optometrists or ophthalmologists). The person taking photos may or may not be qualified to grade the images they take
  • Every grader has to undertake a specialist qualification in grading, they have to take (and score satisfactorily in) monthly quality assurance tests; their grading work is sampled and subjected to QA on a regular basis and they must grade a minimum number of retinal images every year in order to keep their skills honed
  • The images are not usually graded at the time the photos are taken as the images need to be viewed on large screens and may need to be looked at by more than one grader
  • If any sight-threatening retinopathy is seen on the retinal images, the patient is referred to the Hospital Eye Service for further tests to see whether the changes seen at screening are significant. If significant changes are found, the patient will be kept in ophthalmology and may be offered treatment. If changes are not significant, the patient will be returned to screening (possibly in a surveillance pathway)
  • Although other non-diabetic retinopathy eye conditions may be detected during screening, this is not the aim of screening and all patients are advised that they should also attend their optician
  • All screening services (including private contractors) are monitored for quality by the National Diabetic Eye Screening Programme. Health Intelligence has been running eye-screening services for years and has successfully tendered to run new services in the last couple of years. If they were not meeting the national standards for screening, they would not be awarded new contracts.
It is difficult enough to allocate appointments in the Hospital Eye Service for those who need treatment. It would be a waste of precious resources to give those appointments to people who do not have sight-threatening diabetic retinopathy, something that can take many years to develop, if at all.

Regarding your wife's test, she should get a letter with her results within 6 weeks of the screening test. If there is sight-threatening retinopathy (including diabetic maculopathy), she will be referred for further tests in the ophthalmology department. If no diabetic retinopathy (including maculopathy) is detected, she will be asked to come back for screening next year.
 
This has to be a matter of personal choice. I first had photocoagulation in the winter of 1978, when it was almost unheard of. The lasers were far more damaging than now, and even as I type this, I am aware of scarring. But, I am able to see and drive 39 years later, without any form of visual aids. Even though I had a pancreas transplant 52 months ago, thus stopping further damage from Type 1 diabetes over a period of 54 years, I choose to attend the East of England Retinal Screening Service. Not only is it possible for my eyes to deteriorate due to damage in the past (I last had photocoagulation in 1983), but also the DVLA would never renew my licence without the evidence. The biggest cause of blindness in diabetes is retinopathy, essentially because the capillaries that feed the eyes are at an extreme terminus of an already challenged circulation. To compensate, they proliferate and begin boring through the retinas. This excerpt, from Fifty Years of Malfunction, is a graphic description of my first experience:


It was at this time that King’s College Hospital noticed the first signs of retinopathy, a word I had not yet encountered. I was well aware that many elderly diabetics were blind and I was reminded of this every time we drove past the iconic 1930s St Dunstan’s Home in Ovingdean, a little East of Brighton. Their Website has a section on diabetes. With this in mind it is remarkable that I am writing these words some thirty years later (now thirty-six). One evening, in my first year at King’s, I was sitting at my desk, amazingly doing some work, when I was suddenly unable to see out of my right eye. It was as if a bottle of drawing ink had been poured into the eyeball. Various ideas flooded into my imagination, almost as rapidly as the real substance into my sight. Blind panic took control. I ran down Champion Hill and across Denmark Hill, straight into the Hospital, I would guess in under sixty seconds. Arriving at Accident and Emergency, I was greeted by the ubiquitous unsympathetic gaze of a receptionist:


“What’s your problem?”

“I can’t see out of my right eye.”

“Who sent you here?”

“I did.”

“Did you contact your GP?”

“Listen, I’m an outpatient here and I’m diabetic” (magic words).

“Oh, I see, do you know your Hospital Number by any chance?”

“Yes, A153034.”

“Fantastic. Ah, Mr Vicat. I see from your notes that retinopathy has been noted. I’ll get someone to attend to you.”

A doctor duly appeared and informed me that I had had a haemorrhage and that nothing could be done until it had cleared enough to see what damage had occurred. I was put under the care of Mr E.W.G. Davies, a short, wire-rimmed-bepectacled man with whispy grey hair, twinkly beaming eyes and an everlasting supply of Fox’s Glacier Mints stuffed into his white coat. I found this ironic, seeing that the majority of his patients were diabetic! During one of his consultations in my second year he asked me about my life. I told him that I was living in Kensal Rise; that I cycled into King’s College in the Strand every day; that I played squash; and that I drank moderately (I’m sure he didn’t fall for this). His response was that I should stop burn-ups on the Edgeware Road, that I should avoid squash, moderate my alcohol intake, and that I should shun aerobic exercise or anything that would make me red in the face. If I did not heed his words, I would be blind by the time I reached twenty-three.

I have had my eyes screened every year since.
Of course diabetics can suffer all kinds of eye problems, but several of my acquaintances who have varying degrees of macular degeneration do not have diabetes of any description.

Please do not dismantle the Eye Screening Service!
 
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You are deliberately missing the point.

You did NOT take your wife to a full diabetic eye check appointment.
You took your wife to a specialist eye screening service which was looking for one thing and one thing only - diabetic retinopathy.

There are a number of specialised services which go out into the community and test for only one thing, including glaucoma and breast cancer. As far as I know none of them test for any other conditions. This is the way the services have been designed and the way that they have been implemented.

If your wife has known sight problems then she should be under the care of a local optometrist or a specialist eye clinic which is intended to diagnose and treat her eye conditions.

It just so happens that I have the standard brochure in front of me now, as I am due my annual eye screening in early January.

This includes the words "Screening does not look for other eye conditions and you should continue to visit your optician regularly for an eye examination as well.". This seems pretty clear to me.

The brochure says that you get drops in your eyes, photographs taken of the back of your eyes, results about 6 weeks later. So it seems clear from the brochure that ALL you are getting is photographs of the back of your eyes.

I am assuming that you are making sure that your wife has comprehensive eye care from a suitably trained specialist.

Meanwhile, ranting about a service not delivering things which it was never intended to deliver seems remarkably unproductive.

I do note that the accompanying letter from my local NHS on behalf of the eye screening service (not the standard brochure which should go out with all the eye screening test appointments) it very woolly and vague.
My copy says "The aim of eye screening is to detect any changes caused by diabetes that could cause damage to your sight." It also says "Helps to detect any risk to your vision caused by diabetes."
These statements are vague and potentially misleading, and I will raise them with my local NHS and Diabetes UK.

I was involved in the design of the brochure in conjunction with Diabetes UK so I will try and track back and see if there is anyone still around who can take up the issue.

However it is very clear that the service your wife attended is not a scam and you should perhaps be a little more cautious in the ways you go about defaming a legitimate service provider providing a legitimate service.
 
I have now written to a contact within Diabetes UK, and also to the eye screening service for my area.
We shall see what (if anything) happens.

For a bit more information; the NHS is not a single entity but a loose grouping of (sometimes) cooperating areas.

Some years ago Diabetes UK was involved in the design of a standard brochure explaining about diabetic eye screening. A soft copy of this and some suggestions about the format of the accompanying letter were supplied to the NHS but each bit of the NHS has its own ways of doing things so it is likely that there are small (or large) differences in the fine detail of the booking letter.

It would be useful if anyone receiving a booking letter for eye screening checked it for inaccurate and misleading statements and reflected any issues back to the booking office for the eye screening programme.

If enough people complain about the same thing, who knows? Something might be done!
 
I was sent for a retinopathy scan. Chart, drops photos. Came back clear BUT I was not advised to visit anyone else to check whether there were other problems. Maybe it's my own stupidity that I didn't go elsewhere, but maybe it should be included in standard advice to new diabetics.
 
You shouldn't blame yourself - diabetes has a bearing on every bodily system, since it affects how energy is distributed. I have been lucky in the sense that in years gone by, there was nothing like today's technology, but the NHS had more funds and time to deal with people like yourself. I think including this in standard advice would be beneficial, not just to patients, but also to keeping medical costs down. I wish you the very best of luck.
 
If you had any other problem then I am sure you would have symptoms of it and then would see an optician or your GP about it
 
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