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##UPDATE##. Spot in Vision - retinopathy related?

Discussion in 'Diabetic Retinopathy' started by Emck, Jan 17, 2019.

  1. Emck

    Emck · Active Member

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    Not sure if this is the right forum for this question, but I can move it if needs be.

    For the past three days I have been experiencing a spot in the vision of my left eye, it only appears in certain light conditions (in my bright white bathroom, in dim-ish office corridors) and having done a make-shift Amsler grid test I can see that the spot appears in the centre-right of my visual field, towards the bottom. Sometimes when I'm working at my computer or watching TV it appears briefly, like a spark of glitter in my vision.

    I have had floaters before and this doesn't seem typical... The weird thing about this spot is that it only appears when I blink (in the millisecond before my eye closes/after it opens - I can't tell it's so quick)! As far as I can tell, it's a bright spot with a greyish/green tint (i think), like the after effect of a bright camera flash.

    At my last eye-screening I got a letter saying that I did have some retinopathy. The letter was so unhelpful though, it didn't state the severity or which eye was affected. My DSN thought that this would likely be background, as I was just put on the annual recall list.

    My next screening and consultant appointment is due around now (strangely I haven't had a letter yet - must be standard NHS delays).

    Has anyone else experienced these odd spots of light, or know whether they are retinopathy related. I've booked an opticians appointment, but the nearest I could get was in a week.
     
    • Hug Hug x 1
  2. Knikki

    Knikki · Guest

    To be honest very difficult to tell, if you do a search on these things what you have already experienced points to possible retinopathy BUT I AM NO OPTHALMIST.

    The letter from the NHS is the standard one nearly everyone gets.

    The only way to know is either wait for your next appointment or push for an earlier check up.

    Sorry can't be more helpful than that.
     
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  3. LeftPeg

    LeftPeg · Well-Known Member

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    I'm in a similar boat, but as Knikki said, all you can do is wait to see a professional. I've got my debut eye examination next week. I have an awful lot of floaters, which doesn't bode well, but then again I've had floaters since childhood so it may not be related.

    Best of luck at your next test - hopefully it's nowt.
     
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  4. Emck

    Emck · Active Member

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    Vision is just a scary thing isn't it! My optician's appointment is next wednesday and he is an ex-eye surgeon who does a very thorough exam, so if there is something there I hop that he can pick it up.
     
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  5. DCUKMod

    DCUKMod I reversed my Type 2 · Expert
    Staff Member Administrator

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    @Emck - I wouldn't like to speculate about your eyes, but going back to your comment about the unhelpfulness of the rerinopaqthy screening letter, it is worthwhile noting that whilst the patient receives what can, at best, be described as a bland letter, your GP will receive a more detailed version.

    In your GP's letter they are informed of whether one or both eyes are impacted and to what grade, on a numerical scale. The grades are detailed and explained on the link http://www.diabeticretinopathy.org.uk/gradingretinopathy.htm

    Whilst that in itself doesn't help you right now, you could ask your GP for a copy of that letter. If you don't fancy an appointment just for that, perhaps you could write to him/her and ask for it, or have a telephone consultation.
     
  6. Dark Horse

    Dark Horse · Well-Known Member

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    If you attend eye screening regularly, any possible sight-threatening diabetic retinopathy is usually detected before any symptoms appear. Your description doesn't sound like the symptoms of maculopathy (blurred vision which can't be improved by glasses) or proliferative retinopathy (sudden onset of red or black floaters). Keep your optician's appointment next week but if you experience a sudden increase in flashers and/or floaters or get a 'curtain' across your vision, don't wait for the appointment and go to eye casualty.
     
  7. Emck

    Emck · Active Member

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    Thanks for the reassurance @Dark Horse.

    Just back from the opticians, he did a thorough slit lamp exam and says that my retina looks very healthy and the likelihood is that the spot (which has gone now) was most likely a big ol' floater.

    Additionally, because I am short-sighted I am more likely to see floaters. I am also at a greater risk of retinal detachment, so it's good to know the warning signs just in case. He said that the most common sign is seeing a lot of floaters in one eye, and that if that happens I should go straight to A&E as urgent surgery has a good chance of saving sight!

    I had a chat with him about the retinopathy screening letter too. He says that as there was no great detail, it was likely that the retinopathy that they saw was probably next to nothing. He has worked as part of the review team and says that they get the pics on a massive screen and can magnify them to great detail. Even one tiny micro-aneurysm can count as 'background', though this will normally resolve itself with good control of BSL.

    Thanks for the support on this, eye health can be very stressful!
     
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  8. Mr_Pot

    Mr_Pot Type 2 · Well-Known Member

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    It is good to hear confirmation of what I was told at my annual retinopathy exam. There have been those on here who seem to think that their eye test and retinal photograph reviewed by their optician on a small monitor should be sufficient.
     
  9. Emck

    Emck · Active Member

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    Sorry to bump this one back up again, I’ve just been for my annual NHS screening. The technician said that he could see leakage in my left eye, near my centre of active vision.

    This is just 6 months since I saw my own optician and had the back of my eyes checked. I asked what next steps would be and he said that I would likely be referred to the eye clinic.

    I’m freaking out.

    Has anyone else had this kind of report at a screening?? I’m so scared.
     
    • Hug Hug x 1
  10. Dark Horse

    Dark Horse · Well-Known Member

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    If you are referred to the Eye Clinic, they will do an OCT test - it is only then that they will know whether the leakage is significant. If there are no significant changes, you would be referred back to screening. If changes are borderline, you may be monitored in hospital until the changes clear up or become significant. If the changes are significant, you may be offered treatment. Treatment is most successful when caught early, as in this case.

    At this stage, you just need to worry about continuing to keep good diabetic control and making sure you attend all your eye appointments.
     
    • Agree Agree x 1
  11. Emck

    Emck · Active Member

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    Thanks Darkhorse.

    My dsn has just emailed to say that I have changes in both eyes that require more investigation. This has just come as a big shock, given that my eye doctor looked at my eyes in January and saw nothing to worry about.

    I guess that knowing is better than not knowing. At least I can be referred to doctors that can hopefully help to treat me.

    It has become obvious over the past few months that my current insulin regime wasn’t working for me anymore. I have had a good hba1c, but in reality I have been swinging between high and low. Hopefully I can catch this and improve my control again before it gets worse.
     
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  12. Emck

    Emck · Active Member

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    I have just now got my result letter:

    Possibly maculopathy, which I was expecting given that the screening technician mentioned that this was near my central vision.

    I have been referred urgently to have further assessment, I think that this is because I am attending a pre-pregnancy clinic and my dsn emailed the consultant as soon as she had my results for a quick referral.

    I am trying very hard to maintain good control, which is difficult as my dawn phenomenon is a constant struggle.

    The referral letter says to expect that I will be in the clinic for a minimum of 2-3 hours, but I will not be having surgery on this date.

    I am glad to have confirmation of this, after being so scared by the technician almost a month ago.
     
  13. Emck

    Emck · Active Member

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    Oh and one more question on this that I’m hoping the community might answer

    I had a vomiting bug a few months ago that caused visible haemorrhages to my eyes (I.e in a mirror I could see new redness on the white of my eye. Could his have caused my background retinopathy to have worsened/progressed?
     
  14. Dark Horse

    Dark Horse · Well-Known Member

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    The increased pressure in head and neck veins from vomiting can cause a specific type of haemorrhage in the eye:- https://eyewiki.aao.org/Valsalva_retinopathy

    I've not come across any reports of it being related to exudates (the leakage seen in maculopathy).
     
  15. Emck

    Emck · Active Member

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    Hi All, I just wanted to give an update of how my referral appointment went.

    Personally, I suffer from a lot of anxiety around these kinds of things (so I wanted to outline the process in case it might help anyone going through the same situation):

    • I was brought in an met by a nurse who firstly carried out a vision test (reading letters off the chart), she checked my blood sugar (using my own libre), my blood pressure and my eye pressure (using a little hand held device that puffed some air into the eye.)
    • The nurse asked me a lot of questions (do I smoke, do I drink, do I have a family history of eye problems, do i have a family history of heart problems etc.)
    • The nurse popped in some eye drops to dilate my pupils ( a bit stingy but nothing too bad). I'm sure most people with diabetes have experienced these before, but they make your eyesight a bit blurry for a few hours (I found reading hard and lights very bright).
    • I was then brought in for an OCT eye scan.This is the same format of procedure as the standard retinal photograph (chin on chin rest and look into the lense) it takes about 1 minute and is not invasive.
    • Then I was brought out to meet the consultant, who chatted through the OCT scan results.
    In my case, I was lucky that the spot of leakage that was seen was not in my macula, it was just outside of it. I will be recalled to see the doctor again in 3-4 months to check whether it has stabilised/progressed.

    The doctor was fairly confident that stable sugars should keep this in check and that if I can keep my control tight this should resolve on its own. She did mention that leakage like this can take up to 2 years to go away.

    I'm really hoping that I can keep my control steady and recognise that I am not out of the woods just yet!

    Thanks for all of the input on this thread. This community is so helpful and understanding!
     
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