I had a diabetic retinopathy test today. I had a retinal OCT (optical coherence tomography) test, and a slit-lamp exam.
The test report output gave ranges with color-coding - green, yellow, orange, and red.
Green is normal, all good.
So after just a couple years of having diabetes, everything was normal for me today. The doctor said my eyes looked great.
Posting this just for the benefit of the long-view…
Parents, target normal BG. I know it is not easy, and I know it takes a lot of work. And yes, spikes happen. Sometimes things don’t make sense. But knock that BG down aggressively. A short spike is no big deal. Longer lasting spikes are the concern. Insulin is your best friend.
The recent trend of recommendations toward higher and “safer” numbers…I’ve got a lot of years backing me up to dispute it. High BG is the enemy. Aggressive treatment is the best. I have never regretted it.
I had my test today. Both the slit lamp exam and an Optos image (first time I’ve had that done). She looked at the Optos image first and then did the slit-lamp exam. Always anxious to hear her say “No DR” as her nurse takes notes.
I really liked her looking at the Optos image first, because she noted an area that potentially looked troublesome with the right side of my left eye. She really looked at that area during the slit-lamp exam, but everything was normal.
I had my first a few months ago as a result of an exam by my principle eye doctor who referred me to a retina specialist as a precaution (she didn’t think what she saw was was particularly worrisome). I’ve had retinal pictures taken, on and off, since the start of the '90s; I was getting them done regularly in the UK 30 years ago but that pretty much stopped when I emigrated to the US and, indeed, the pictures I brought with me got lost in the records.
I started doing the Optos stuff as soon as my PED had it available, I think at least 5 years ago but not more than 10; I had to pay for it myself at that time but the canny Scottish company in question made it pretty cheap, $25 I think.
I’m in accord with my original endo, Dr Henderson, who started me on this. He was (I hope is) a T1D too and he inspired enormous trust in me. There is no centralized record keeping in the US of course and the centralization of records was in its infancy in the UK at the time, but the enormous importance of this to those of us with chronic conditions can’t be overemphasized. The Optos images, or, indeed, the 35mm film I brought from the UK, show the changes (you’ve seen the doc switching the Optos images, right?) both over the short term (since the last visit) and the long (since my first retinal image, aargh, someone lost it).
The 3D imaging is an extra dimension to this; the doc can look through your eyeball as though it had been sliced on a microtome. I can only imagine that the value to us of those images over the years are potentially enormous. At present, 47 years into T1D, I’m looking at something near to the fovea and, I think, the optic nerve which might be a problem; next check in February.
The other curious experience that came out of this was having a doc squeeze my eyeball quite hard (perceptually). Interesting.
This was my first Optos image so there was no switching of images, but I agree the ability to compare images over time sounds like it would be very beneficial.
I agree about keeping BG in check. Unfortunately i do have a couple of small retinopathy areas in my eye. Pretty stable. Have never had an A1c over six. Usually around 5.6. So complications can happen with good control. Best to you.
And people who don’t have diabetes at all can certainly get retinopathy… but Of course poor diabetes control certainly increases the likelihood
A lot of non diabetics go through their whole life happily not knowing they have “non proliferative retinopathy” and not caring… simply because nobody cares to check for it unless you have diabetes
Thank you for your response. Not too worried about my retinopathy. I have LADA so who knows if it has been developing for years. Diabetes is such a perplexing disease. We do our best.
That is very good news. Like you I have had T1D for now more than 45 years. About 20 years ago I did have some retinopathy. After going on a very aggressive MDI and lowering my A1C to 5.8 I now have no indicated retinopathy. In addition to my CGM system I try to follow Dr. Richard Bernstein’s suggestions in his book. I am not as strict to following his limited carbs. but come close for each meal.
