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optometrist would like opinions on retinal screening

Discussion in 'Diabetes Discussions' started by optometrist, Jun 11, 2009.

  1. optometrist

    optometrist · Newbie

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    hi, i am not a diabetic , but am an optometrist, in north west who is also a member of a local optical commitee (loc). we meet to discuss topics relevant to local community optometrists, liase with primary care trusts etc, one of the topics being community retinal screening by community optometrists in practice. in yestedays loc meeting the retinal screening was discussed and we all thought that it was of great benifit to the diabetic population! however nonone has yet asked the diabetics how they feel about it! hence this post. i am paticully interested in comments by diabetics who have a choice of screener eg community optician, hospital based , " man in a van" mobile screen. the reasons as to why they chose which provider , how was the experience, was it good to be able to have a sight test at the same time as screen, did you feel pressured into buying specs?- would that stop you going back to that optician again? does any one attend one optometrist for screen and another for specs? is it considered a big benifit to have " capture " ( ie photos) and "grade" (the process of determining the level of retinopathy, if any) on the same day? ( in some areas these 2 parts are sepperated) i do not screen personally nor am i a practice owner so please be frank with replys. however it would be helpful if comments related to diabetic retinal screening alone were posted , and not drift into other topics. i intend to show results to committe at next meeting. any who do not want their comments shown please indicate so. i will be removing names of any practices /screeners that may be referred to. i shall of course give the scource of the comments as the "diabetes uk forum". any questions please ask. i have already seen thread *eye screening , do i have a choice of provider* any other threads you think may help please let me know
    thanks
     
  2. sixfoot

    sixfoot · Well-Known Member

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    Maybe im fortunate but i live on south coast in Sussex, I get retinal screening via my local hospital annually which is free. Last time i had a couple of tiny spots in left eye but this time they have gone. My father used to have lots of laser treatment due to bleeds found on screening so because of tight control i hope to prevent / delay that happening to me

    Dave P
     
  3. peppiB

    peppiB · Well-Known Member

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    I live in north east England and my screening is done annually at the hospital based centre. The service is free. Most of the local opticians offer the service but at a charge.
     
  4. chocoholic

    chocoholic · Well-Known Member

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    I am really lucky to have an excellent optician who I see annually for normal eye-sight testing and diabetic retinal screening, all in one appointment.They have all the latest equipment and I have every confidence in them. I get a postal reminder from the hospital every year, who send me a list of those they recommend for specific retinal screening and the one I choose from that list is highly thought of,locally,by many residents.
    I think retinal screening is vital for all diabetics, though I worry about the brightness of the light that photographs the back of my eye.I'm sure it would not be allowed if there was any chance of 'damage by testing', so that's probably just me being a Mrs Worryguts but I'm sure all of us would rather a brief, blinding flash to long-term eye problems due to non-testing.
    I am on the Essex coast, if that info is of any use and my optician does not charge for retinal screening.
     
  5. gbtyke

    gbtyke · Well-Known Member

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    My retinal screening was done at local hospital - no mention made of eye tests at same time.
     
  6. totsy

    totsy Type 1 · Well-Known Member

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    im in yorks and have mine done yearly at the hospital, i know some opticians are doing this also but will stay with hosp one for now :D
     
  7. MaryChristine

    MaryChristine · Well-Known Member

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    I live in the north west of England.

    I was diagnosed with DM Type 2 after my optician (to whom I shall be eternally grateful) observed retinal changes at a routine eye test. He recommended that I have digital retinal photography done but his practice did not offer the service.

    Despite having retinal changes at diagnosis, I was not initially offered screening or referral to an ophthalmologist through my doctor, as I (naively?) assumed would happen but eventually, when I asked about it, I was sent details of the local programme and a list of opticians who could do the photography. I simply had to make an appointment at a convenient one and have it done. There was no pressure to become their client, have an eye test or buy spectacles. I can remain with my original practice for further eye tests, although, sadly, the person who diagnosed the retinopathy has left, and I am considering changing to one nearer my home.

    There was a delay in receiving my results as some paperwork had gone astray but this was eventually sorted out.

    I was then referred to the local hospital ophthalmology clinic. Presumably the retinal images have been included in my records there. No further photographs have been taken but I am now waiting for an appointment for a retinal scan. I do not yet know whether future retinal photography will be done by the hospital or optician.

    Overall the initial screening was easy and convenient, confirming the diagnosis and providing a useful baseline record.

    I would have liked to be given a print-out of the images, and subsequent ones, for my personal records, and a more detailed written assessment but appreciate that this would add to the cost of screening.

    MaryChristine
     
  8. kegstore

    kegstore · Well-Known Member

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    I'm in Bristol and have used the same (excellent) optician for sight tests, glasses etc for 14 years. They were the first to pick up on the initial changes in my eyes, and referred me on to the eye hospital for treatment, and where I now have regular (every 6 months) screening. I wouldn't change my setup for anything.

    Interestingly my optician is normally at least 2-3 years ahead of the eye hospital in terms of technology, and currently has some quite amazing equipment. I get emailed all my retinal scans, carried out without those miserable dilating eye drops, and as good as - sometimes better than - the hospital pictures!
     
  9. IanD

    IanD Type 2 · Well-Known Member

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    I've had annual screening for nearly 10 years, first at the Moorfields visit to Ealing Hospital, now at a Southall clinic under the auspices of DRSS. They always do a sight chart test before dilating the pupils. I have got slight retinopathy in one eye. Its been like that for several years & not progressed.

    This thread didn't get very far.

    My optometrist uses drops to dilate examine the retina. He's not "pushy" - he's been testing my eyes for 10 years & my prescription hasn't changed, nor has he suggested that new glasses might be beneficial in some way (like others have - sometimes for the worse, the benefits were so marginal.)

    I've just had a very thorough examination as part of the 17-year follow up to the Southall & Brent heart & diabetes project - retina, & lens photographed to look for signs of cataract, even the lens cross section. St Mary's Hospital, Paddington did the tests. They also used all available non-invasive "machinery" to test heart & brain, & neck arteries.
     
  10. jeenie1940

    jeenie1940 Type 2 · Well-Known Member

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    My 1st retinal screening was done at local hospital 13mnths after dx ,
    i,m now waitng for results
     
  11. IanD

    IanD Type 2 · Well-Known Member

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    I always ask the technician - they will normally give an opinion, subject to the Dr's report.
     
  12. hanadr

    hanadr · Expert

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    I am a spectacle wearer, so was seeing opometrists regularly before my T2 was diagnosed( not by them) I have mild retinopathy, which caused the optometrist at "Boots" to flip, even though I warned her about it, and insist I go to the hospital. That caused so much trouble with their appointments system, that I am determined NEVER to let it happen again. I have seen the Visiting technician at my health centre and that was a good experience, I have also been to the Hospital to the Diabetic Retina clinic and felt like I needed my sleeping bag, the wait was so long.
    Last time I needed new glasses, I went to Specsavers, where the optometrist was sensible, told me my retinopathy is very mild and did the field of view tests too.( I scored 100%).
    The experience seems to depend most on the individual optometrist. Obviously, monitoring is good for us
     
  13. Bluenosesol

    Bluenosesol Type 2 · Well-Known Member

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    On diagnosis, I was told that part of my initial testing would include retinal photographs, which would be repeated each year. I was provided with a list of approved opticians in the locality who could provide the service and chose one in our local high street. I attended only this week.
    It was my first one and hence I was extremely apprehensive. The opthalmist offered my wife and I a drink and then took me to the treatment area. He told me exactly what was happening and advised that the results were instant. He showed me HD images of my eyes and explained to me that he could not have predicted my diabetes based on the results and that my results were perfect.May not seem much, but for someone who has been frightened to death by results to date and the associated interpretations, this was welcome news indeed, especially when the opthalmist advised me that there was a good chance that the rest of my vascular system is probably in good nick based on my eye results.
    He then downloaded the results onto the NHS database and told me that any degradation now would be picked up early by year on year comparisons of new versus previous images.
    I thought it was a great service conducted in a low stress environment.

    Steve.
     
  14. Talia

    Talia Type 2 · Member

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    Hi
    I live in Coventry and have annual retinal screening at my GP surgery. A optometrist from the Coventry and Warwickshire Hospital Trust comes and screens all the local diabetics. They have access to previous years results and can tell you at the appointment whether any changes are observed. A letter is sent a few days later with the results of the screening. Vision is checked before drops are put in.
     
  15. ShyGirl

    ShyGirl · Well-Known Member

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  16. Dennis

    Dennis Type 2 · Well-Known Member

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    I live in Surrey and have retinopathy screening each summer arranged by a local hospital. I also have my sight tested each winter at Specsavers who, until a year ago didn't have retinal photo capability. Now they do and they include this as part of their tests, so I effectively have retinopathy tests at 6 monthly intervals.
     
  17. pedro606

    pedro606 · Well-Known Member

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    I was diagnosed T2 diet controlled back in January this year.

    This morning I actually had my first retinal screening. I live in Caerphilly Borough in South Wales. The screeing is done by the NHS at a dedicated building inthe town where I live.

    In the appointment letter it explained to me why it needed to be done and when I would receive results. I was also advised to bring some sun glasses as well. I was impressed with the letter. I was also advised not to drive but to take public transport or walk or make other arrangements etc.

    I was met by a Health care Assistant who explained again what was going to happen and she put me at ease. She also did an eyesight test on both eyes(normal stuff). She asked me a few health questions etc and I had to sign a form. Some drops were then put in my eyes which stung a little but nothing too painful or distressing! She also did some sort of a check on my glasses.

    I was in the waiting room for about 10 mins or so and then was called in for the 'photographer' to take pics inside both eyes. Obviously special equipment used for this. He explained what he was doing as he went along.

    When he was satisfied that all the pics were OK he then told me they would be seen by an expert to make some sort of diagnosis etc. This would take up to 8 weeks or less. A letter will then be sent to both me and my GP and then decisions would be made from that.

    I am glad I took the sun glasses with me as it did affect my eyes when I went outside into the daylight. I was OK after about 3 hrs.

    All in all a very impressive appointment.
     
  18. optometrist

    optometrist · Newbie

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    thanks everyone for their response. i get the impression that most persons are more or less happy where ever they go- exceptions noted. a few thoughts that may be helpful.there should be no charge for screening as it is funded by nhs.however it may be that some optometrists will charge if they are not accredited to a screening program and they offer as an extra service photographs which they then check themselves. this would not be part of the NHS screening program; you would still need to be screened as part of the program by someone accredited to it. it is also possible that an optometrist who is accredited and is carrrying out a screen, may offer as an extra service, additional photos, and to save the other photos on their data base as a reference for future comparison . this additional service would not be part of the screen and of course would be optional. the actual screen is rather carefully defined with minimum standards though they can be exceeded, but there may be a charge for this if offered privately by practise rather than as part of an agreed protocol, funded by nhs. if any one is not quite sure what they are paying for then ask what precisely is the fee for. you may feel that any additional fee is well worth paying , but it should not be thought of as something necessary for the program. also the *standard* periods between screen is 1y, which is statistically thought to be fine for those with no or mild retinopathy. in these cases there would not usully be nhs funding for any additional screens, so if you want another one early you will usully have to pay.(more severe retinal changes would warrant an earlier funded rescreen). there is a facility for a nhs sight test earlier if problems present, ( other reasonds for earlier sight test may also occur) which may lead to a referal to an eye dept, but this is not a " screen" it is a sight test. this may all seem a little pedantic but there are quite definite differences in the intent/ purpose of the appointment.
    comments restricted to england. there may be local agreements that exceed the nhs requirments. there may be local transitory arangements in place until the whole system is fully operational. if any one has any queries that i may be able to help with from the "other side of the desk" happy to help.
     
  19. Graham1441

    Graham1441 · Well-Known Member

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    Hi,
    I have my eye photo done at a clinic which is not great, its not the clinic thats fine but its getting home after with blury sight, its a bus ride as well.

    I go to Specsavers firsty because of the service i have had in the past, WELL DONE SPECSAVERS, I was going in there every week for new lenses and they gave me the eye test for free and where so understanding. They also do a flexable frame that stops me bending them either at work or when I fall asleep in the chair.

    If there was the option of the eye photo in Specsavers once a year for free and maybe a charge if i wanted another half yearly or even quartly Specsavers would make money and Diabetics would be able to keep, oh hell sorry about this, a close eye on there sight, lol.

    Graham1441 :twisted: :twisted:
     
  20. goji

    goji · Well-Known Member

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    I get my standard eye tests done at Specsavers as they supply my contact lenses and they had a decent range of glasses with some good discounts for students etc. I wish I could get retinal screening done there as it would make things a lot easier but they said they don't do it.

    In north london, there is a choice of local opticians who are contracted to provide the retinal screening service. I saw the one nearest to me. He had just invested in a photographic machine (to take photos of the retina) and gave me the choice to have photos (for £12) or no photos (free). I opted for the photos. I'm querying after reading others' posts on here why I had to pay for it.

    However it was helpful to have the photos as the opthalmologist could point out a small area of damage. I was less happy though about being pressurised into looking at new glasses (I just got a new pair of glasses from Specsavers) and this made me question whether or not to go back to that service. I understand that the opthalmologist is just trying to make a living but I don't take well to the hard sell especially as I only went there for retinal screening. If you present this to your colleagues then please stress this point.

    I didn't get any written information about my eye screen. I wish that there was some kind of documented record sent to me as my doctor has never once brought it up so I don't really know what the outcome was.
     
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