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Retinopathy eye test

I had my annual retinopathy check today. I am in the USA. The eye doctor dilated my pupils, then looked at my eyes with the usual gadgets, then said there is no sign of retinopathy. I said to him that I had heard some clinics (in the UK, but I did not say that) take photos that are analysed later. He said yes, that does happen but only at facilities where the staff are not qualified to do the instrument check that he did.

Is it the same in the UK, or are those photos taken and analysed even if the person doing the exam is a qualified eye doctor?

Anyway I am pleased with the result, because I had read that a rapid *change* in A1c (in my case, downwards, after my diagnosis a year ago) can cause retinopathy regardless of the direction of movement. I asked the eye doctor today about this, and he confirmed that yes, a sharp drop in A1c such as I experienced when going low-carb can sometimes trigger retinopathy.
 
In the UK we have a national retinal eye screening service, paid for by the NHS. This is where most of us go. The eyes are dilated and images taken. We can see our eyes on a screen. The technician checks the images to make sure they are clear, not blurred or whatever, but isn't qualified to give us a definite result. The images go away and are looked at my qualified staff on much larger screens.

We also have the option of by-passing this service and going to a suitable high street optician that has the required machinery. Some of these opticians are better than others. Personally, I trust the national screening service more than a high street optician, but that is only my opinion. (some of them don't even get an eye sight prescription right!)
 
Grateful said:
I had my annual retinopathy check today. I am in the USA. The eye doctor dilated my pupils, then looked at my eyes with the usual gadgets, then said there is no sign of retinopathy. I said to him that I had heard some clinics (in the UK, but I did not say that) take photos that are analysed later. He said yes, that does happen but only at facilities where the staff are not qualified to do the instrument check that he did.

Is it the same in the UK, or are those photos taken and analysed even if the person doing the exam is a qualified eye doctor?

Anyway I am pleased with the result, because I had read that a rapid *change* in A1c (in my case, downwards, after my diagnosis a year ago) can cause retinopathy regardless of the direction of movement. I asked the eye doctor today about this, and he confirmed that yes, a sharp drop in A1c such as I experienced when going low-carb can sometimes trigger retinopathy.
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The photos are taken as part of a screening test and most are examined by specialists who are not ophthalmologists (eye doctors) and therefore not qualified to do the slit-lamp biomicroscopy examination that you had. Having said that, most screening programmes have a consultant ophthalmologist as Clinical Lead and they may be involved in some of the higher-level grading. Some programmes employ additional ophthalmologists or optometrists for this as well.

The advantages of the screening photos are that they can pick up very early changes that are difficult to see on slit-lamp, screening appointments can often be close to the patient's home rather than having to travel to a hospital eye department. and there is a permanent record so progression can be tracked and any errors investigated. The advantage of slit-lamp biomicroscopy is that the whole of the retina can be visualised. The two departments work in partnership - any suspicion of sight-threatening retinopathy, the patient is referred into the hospital eye department for further tests. When the eye department is satisfied that there is no current danger, the patient is referred back to screening for regular monitoring.
 
Dark Horse said:
The two departments work in partnership - any suspicion of sight-threatening retinopathy, the patient is referred into the hospital eye department for further tests. When the eye department is satisfied that there is no current danger, the patient is referred back to screening for regular monitoring.
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It sounds like a good system! The eye doctor today (a new one I had not seen before) was very helpful with information. I asked him about retinopathy and he said not only was the check important in terms of eye health for diabetics, but it was also useful as an early possible indicator of other diabetes complications. For instance, he said that the damage to the small blood vessels in the eye is not unsimilar to what happens when diabetes damages the kidneys -- and therefore any sign of retinopathy would be a clue that other things should be checked out too.
 
Mine should be due anytine Had my annual eye test this week and the optician was happy enough - just a small change in the prescription for my reading glasses.

This will be my fourth scan since I was diagnosed - first came back with background retinopathy, second came back clear and the third last year was showing background retinopathy again.
 
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