Retinal scan results frustration!

Often some of the first "diabetic changes" to be picked up buy a retinal examination or scan are what are termed as "cotton wool spots". These are small swellings in the surface of the retina that occur because of some degree of impairment in the blood supply to the retina. It's the stage before retinopathy has even started, so if you can get on top of the factors that may be causing the problem (blood pressure, good control), any further damage can be mitigated.

My optometrist first observed these changes 16 years after diagnosis, and referred me to an opthalmoligist at the eye hospital. 12 years on and I have proliferative retinopathy, with around 6,000 laser hits in each eye, but my retinas are now stable, I still have excellent vision, and this is down to getting my blood pressure sorted (and the excellent care at the eye hospital).

I had a similar letter and was frantic as I have had diabetes for 41 years.
I complained that it was shocking news to receive in a letter that you have changes.(consultant disagreed with me).
I thought that was bad enough but I have just recently been for Retinal Screening again and again received a letter now telling me that I have Diabetic Maculopathy and may need laser treatment and will be sent an appt for the eye clinic within two months. I phoned my GP and my diabetic nurse to ask some questions but they didn't have any answers for me.
The funny thing was that It said in the letter I should try to ensure my blood pressure and blood sugars were kept to normal levels. They were before I received this letter!!!!!!
:roll:

Hi

I had my first retinal screening 3 weeks ago and the fella said very nonchalantly "oh that's interesting" I asked what and he told me I have birth mark, "like a mole" on one retina, then he said, "still, should be okay although they can turn nasty like any other mole" I wasn't told to google it but of course I did and nearly scared myself to death and convinced myself I was going to lose an eye!
Am waiting for the letter with the results but honestly I think some of these so called professionals could explain things a bit better.

Was the same with my ecg, nurse said "that's not tooo bad" what the hell does that mean.

Enter the woman with the "intersting eye" and 2not too bad ecg" !! lol :lol:

I have not been happy with the approach taken by retinal screening. When I went to be photographed the screener said things had got worse than last time but refused to explain further saying I would need to see the doctor. They should either just take the photo and not say anything at all, or if they are going to say anything be prepared to explain.

I then got letter saying I had retinopathy (I already knew about this) and maculopathy (this was new).It was really insensitive to receive this info by letter but I phoned up the screening service and demanded an explanation of the maculopathy.

Then I saw the consultant earlier this week and he said there is NO maculopathy at all! I know they have to err on the side of caution, and could understand if they said the damage was worse than it was or something- but to tell me by letter that I have a condition the consultant then says I don't have at all is just not right. I was really upset to think I had maculopathy, and relieved beyond belief to be told I didn't, but if they weren't sure they should just have said nothing and referred me to the consultant, saying they needed him to take a closer look or something.

Anyway at least they have got the mistake the right way round, ie it's better than being told I am ok then later finding out not I suppose!
So OP i share your frustration

before I knew I was type 2 I was watching tv one sunday afternoon and believe it or not my eyesight just switched off completely, I was almost completely blind except to say for a few dark shadows in the room around me as I tried to move about.

now the hospital eye clinic specialists didnt know what was wrong after nearly a whole day of testing but my optician spent a couple of hours looking at my eyes and knew what was wrong I had dry eye in both eyes.
my eyes were so dry that when I blinked I scratched the surface of my corneas which eventually robbed me of my sight, it recovered with some special eye drops all back to normal except for the diabeties and its effects when sugars go high.

my optician was brilliant he knew much more about my eyes than any so called specialists at the hospital. Now i dont have the yearly tests at the hospital pressure test etc it is done by my opticians they are brilliant and I get a photo of the back of my eyes to with a detailed explanation of how things are, the hospital wont do that for you.

regards Nigel. :wink:

Where I live there's a new system where all diabetic eye screening images go to a central office for expert review. Stored centrally too so whichever optician you go to (from approved list) they can access/compare previous images. Sadly the digital equipment was only introduced here 1-2 yrs ago, whereas I lived in Bucks 10-15 yrs ago and they already had it then. Though the central interpretation is an improvement.

I used to take home a copy of my optician's report to take to D clinic. Last year (under the new system) I didn't get anything - a result letter from central office would only go to my GP. So I rang the central office and insisted on an individual letter with the results, explaining that with nothing in writing the D clinic would insist on putting drops in my eyes and doing it again, on a work day - waste of effort and I'd lose a day's pay. They kindly sent me a letter. I suspect others did the same, as this year's reminder letter says results will automatically be sent to me, GP, D consultant and/or eye consultant if I have one. Its probably easier for this to happen for everyone than getting lots of individual requests for letters. Pester power does work sometimes.

I find it condescending though that I'm not considered capable of making suitable arrangements for myself (given I'm asked when my eyes were checked at every GP or hospital appointment ). Managed perfectly well for 30+ years by simply remembering which month it was due or have it done digitally at the hospital. I'm not stupid, just diabetic. I know not everyone is so well informed or motivated about their condition, but it still seems patronising, especially with a mostly self-managed condition. If I chose not to have the screening that should be up to me, but I can imagine the fuss if I didn't have it done.

I asked to see the images of my eyes and was pleased to see how normal they look. I have background retinopathy, but it's mild and improving. Retinopathy is only visible on enlarged images.
Yes I do know what a normal retina looks like.
Hana

Hi secrettheatre.

Diabetic Maculopathy.
This condition is more common in older, non-insulin dependent diabetics, and is the most common cause of gradual loss of vision in a patient with non-proliferative diabetic retinopathy.

This involves
the breakdown of the blood–retinal barrier
leakage of plasma from small blood vessels in the macula
swelling of the central retina
formation of hard exudates
diabetic macular oedema
does not cause total blindness o leads to severe loss of central vision (1)
clinically significant macular oedema is
retinal thickening and/or
adjacent hard exudates that either involve the center of the macula

Four types of diabetic maculopathy are recognised:
cystoid:
characterised by microaneurysms and haemorrhages but relatively few, if any, hard exudates
the main feature is extensive macular oedema which if persistent, may lead to a lamellar hole at the fovea with permanent impairment of visual acuity

focal - a background diabetic retinopathy, associated with macular oedema and surrounding hard exudates

ischaemic - similar ophthalmic picture to cystoid and differentiated from it by fluorescein angiography

mixed - exudates, oedema and ischaemia
Reference:

Frank RN. Diabetic Retinopathy.N Engl J Med 2004;350:48.

Here is a link to a website which explains in more detail:
http://medweb.bham.ac.uk/easdec/diabeti ... pathy.html

Thanks Cugila, that's a whole lot more info than the screening people sent in their stupid leaflet accompanying the letter telling me I had maculopathy that I later found out I didn't!

Honestly, I find the level of knowledge on this site by so called lay people far exceeds that of many a professional I have spoken to!

i went for my test in august and was told the computers at the scanning center are being up graded so i am still waiting for another letter when to go for the test again my doctor keeps telling me i have not had the test this year has any one else had this problem

After my annual retinal scan I received a letter saying I had a problem but no action was necessary yet.My optician, who is excellent, did a check and said it was so minute it was not worth worrying about and showed me on his computer. I think some experts worry patients with lack of explanation

Absolutely - as I said previously, what is the point of the screener telling me it is worse than before but then when pressed for further info, saying I'd have to wait until I saw the doctor? If they need to screen it properly before they can make an assessment then just take the **** photo and shut up!
I know I should be grateful a screening process exists, and I am, but I worried myself sick for two weeks thinking that I had maculopathy, then found out I didn't - so they definitely need to think about the impact on the patient of how they go about this.

I suppose the benefit is that I know for sure I never want to be in that situation for real, so it's been a quite effective motivator to ensure I look after myself.

I have had a letter back from my annual scan that says I have background retinopathy but no action needs to be taken at the moment. I am very concerned about this. I am 21 and had type 1 diabetes for 10 years. My Hba1c level has been around 7.5 for the past 5 years or so, and my blood pressure is low. As many of you have mentioned, I dont feel there is enough specific information and would have prefered if they had phoned me to explain it more. I feel worried I might loose my sight or something ; I dont really know much about it. Anyone have some reassurance? Thanks.

I just ask to see th pictures.
Hana

Ive only been dx for a few months and have been to the hospital for my eye screening. My eyesight had changed virtually overnight.I went to bed okay but when i woke up i could barely see beyond the end ofthe bed I got a letter within a couple of weeks explaining I had background retinopathy which showed itself as minor anyerismns (not sure how to spell that) and that i needed no further treatment at the moment but must make sure i attend my annual check ups so that if there was any changes it could be dealt with straight away. Now that my BG is going down my eyesight is improving,and hopefully its under control