Eyes

I had an eye appointment last week, where I was told I have “dot-blot hemorrhages” in my right eye. The Optometrist didn’t suggest any treatments or advice. He said he’d monitor it, and see me at my next annual exam. I was provided a new prescription for near sightedness, which I’ve never had before, and an updated prescription for distance.

I forwarded the information to my Endo, who communicated glucose control remains the primary focus (I had asked about any interventions or supplements).

I’m feeling pretty down, and sort of scared, but I’m trying to use this as a catalyst for renewed motivation and change to do better. My last A1C was 9.3, the one before was 10 and before that it was in the 8 range for a few years.

IDK if anyone here has been diagnosed with this and has additional advice, but please feel free to share.

Thank you.

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I think you should see an ophthalmologist right away. I haven’t heard of “dot-blot hemorrhages” before but “hemorrhages” sound like it could be due to diabetes. At least, have it checked out by a retina specialist! The ophthalmologist will probably take many images to identify any damage. I went through this myself, and ended up getting monthly eye injections of Eylea in my right eye. It eventually helped but I still see the ophthalmologist at least every 6 months.

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Thanks for your feedback. I’m curious, you suggested an Ophthalmologist first, followed by “at least” a Retina specialist…does this mean in your opinion the Ophthalmologist is the expert opinion when it comes to Diabetic eyes? I will look for one right away. Thanks again.

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Yes, the opthamologist is the expert, as opposed to an optometrist.

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Agree!!! A retina specialist would also be good, but your symptoms are early and may or may not need treatment.

I had many laser treatments many years ago, followed by vitrectomy later. I had significant eye damage due to T1D and using older insulins and poor advice from early doctors (1965-1988). When I got better doctors, it was after years of high bgs, and damage to eyes. But with treatment through 1990s, my eyes are stable and still able to drive, although night vision is slightly impacted. Also had cataract surgery.

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My first and foremost advice is to immediately see a real ophthalmologist

Optometrists (bet they used a retina photo scanner to make that diagnosis, right?). Are kind of a bullshit deal in that they use those photo scanners to “diagnose” a medical issue, then they’re able to bill your medical insurance…. Total bs.

That’s not to say you shouldn’t follow up with a real eye doctor

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I agree with @Trying , @MM2 and @Sam . You need to see an Opthalmologist ASAP. Look at it this way. An optometrist is someone you see if you scape your knee and need a bandaid. An Opthalmologist is someone you see to replace your knee. One is not like the other. One is capable of simple tasks like dispensing eyeglasses and contacts, checking for general eye health. The other is the expert in all things eye related and the Retina specialist is just that - a specialist in all things Retina related.

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Another way to put it: an Optometrist is a “eyeglasses doctor” who specializes in measuring visual acuity and prescribing corrective eyeglasses and contact lenses. An Opthamologist is an “eye health doctor” who specializes in diagnosing and treating disorders and diseases of the eye. You don’t need an eyeglasses doctor, you need the one who watches out for the health of your eyes.

Early on, my endocrinologist instructed me that a person with diabetes should be seen by a “Board-certified opthamologist.” Not a “glasses doctor.”

As far as getting the A1C down, that’s good advice. Folks here will work with you to help, if you want that. In my view it has little to do with careful eating or willpower or anything like that. It’s a matter of learning some techniques that enable you to guide your BG in a good direction when it starts to wander out of range.

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Thanks all. I have a referral in to an Ophthalmologist who is also a Retina specialist (and my GP explained my situation on the referral). I’ve been told now that his office has the referral, they will triage me. I’m going to phone back on Monday to find out where that’s at. In the meantime, I’ve been doing really great with keeping my numbers steady and in range.

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@jo_jo nicely done. Good luck with your appointment, and do let us know how things go. In the mean time, don’t sweat the stuff you can’t control, and focus on what you can.

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I agree. You Absolutely need to see an ophthalmologist. Good to hear you’ve found one. I’ve had diabetic eye disease, PDR (Proliferative diabetic retinopathy) since 2019 and have had several laser eye treatments as well as a Vitrectomy since then. I’ve been type 1 since ‘91.

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I injured my back in the early 1980’s and was off my bicycle for six months. Saw my opthalmologist and he was alarmed that I had developed diabetic background retinopathy. Back healed, got back on my bike and at the next visit he was amazed–“It’s actually much better!” I don’t think my AIC’s had improved, it was the daily strenuous exercise that did it.

Randy
T1D since 1971

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Thanks for sharing, this gives me a lot of hope! I have a personal training session booked for a week from now and am going to start working out regularly at the gym.

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It is my opinion that everyone of every type of diabetes mellitus should get an annual exam by an ophthalmologist. If the exam shows any retinal changes, then a referral to an ophthalmologist who is a retina specialist.

I believe that the number 1 cause of blindness is diabetes mellitus.

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You may want to ask about strenuous exercise, and if you have active bleeds.

I was not told this and unfortunately had significant bleeds in one eye, likely made worse by not waiting until after laser treatments were done and healed.

But that was in late 1980s, and the treatments today have improved.

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I was wondering about this. I’ll ask. Thank you!

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Always a good move, but consider not being overly aggressive about bringing down your A1c. Rapidly getting under control can paradoxically exacerbate retinopathy, though it will usually stabilize after a few years.

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I actually wonder if that has something to do with where this issue came from, as there was no damage at my last annual appointment. I started the Tandem in the new year, and my control improved somewhat rapidly (from a 10.3 A1C to a 8.0). I’m getting even better now, with my next predicted A1C to be in the 7’s (finally).

As far as what I can find online, exercises to avoid are jumping types, that would “rattle” the retina. IDK for sure though, and I’ve emailed the Ophthalmologist/Retina Specialist to let me know while I wait to see him.

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I want to be fair here and not just trash talk optometrists with a broad brush. I had an appointment at a reputable healthcare organization that I had to reschedule and ended up with an optometrist instead of an ophthalmologist… and it was a very legit medical exam.

I did have one absurdly bad experience with one optometrist. And if an optometrist raised an alarm I’d still immediately follow up with an ophthalmologist… but it was inappropriate for me to be dismissive about them as a whole.

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I agree. It was the Optometrist who found the bleed, so I’m glad for that. I was not satisfied with his treatment plan our lack there of, however (just monitor at the next year’s exam).

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