Another one for 968 (sorry) - Blurred Spot Below Centre

[TedMaul]

Posted about this last year, but have not had much luck getting any more info since.... Am type2 diabetic - a couple of years ago just prior to my regular eye screening, I noticed a slight blurring in my right eye, just below centre. Only noticed it when reading something with significant contrast, such as a word document or ceefax for example. If I was reading a word doc on a screen, i could read it fine but was aware that the line or two below had a blurred spot. On an amsler grid, only the edges of one square would show as slightly blurred

Optician who did eye test said photos showed evidence of micro vascular aneurism. Was referred to Eye Hospital, had several visits, lots of tests and they could see nothing physically wrong aside from the evidence of previous scarring. My vision is 20:20, I can read all the test sheets except the very bottom line, I just get this blurring now and again – it seems to last anything between a week and a month and can come and go with no obvious triggers. Like I say, driving, watching TV, everything is fine, only notice it with good contrast

Has been suggested that keeping blood sugars level (i.e under good control) may help as the blurring could be either blood or other liquid leaking from the scar and causing the temporary blurring, but I have had nothing more specific than that.

Most of the time its fine and I don’t think about it, but some days its very bad and causes me concern. Question is have you seen or heard anything similar?

PS If PH do offer fees, I think you should be 1st in line!

[HUW JONES]

Hi not 968....but it's reassuring ophthalmolgy clinic find little amiss. We do commonly see people with refractive type errors which we believe are due to fluctuations in intraocular pressure occasioned by fluctuating blood sugars so you are likely to be correct re tight glycaemic control. Best wishes.

[TedMaul]

HUW JONES said:

Hi not 968....but it's reassuring ophthalmolgy clinic find little amiss. We do commonly see people with refractive type errors which we believe are due to fluctuations in intraocular pressure occasioned by fluctuating blood sugars so you are likely to be correct re tight glycaemic control. Best wishes.

Thanks - good to know as its very, very bad today for some reason. I say some reason, i'm guessing half a chocolate bar before bed. Also, as the minor blurring has the same sensation as a tiny bit of dirt on the eyeball, natural reaction is to blink more which only makes it worse! Thanks for the info, much appreciated

Mike

[TedMaul]

Just had a letter from the hospital post diabetic screening. It says I have diabetic maculopathy.

Firstly, I am very angry with the hospital consultants as everything in the leaflet provided, pretty much describes word for word what I have described to them. The word doc I wrote describing my symptoms could have been used instead of the leaflet, they are that similar.

Secondly, everything I have read says gliclazones make it worse. I started on these a month or two before my symptoms started. This was put down to a coincidence, which 15 mins on google suggests otherwise

Thirdly I'm really quite anxious. Not bothered by laser eye surgey, but the fact it is a degenerative condition and it could get worse. Huw/911 have you any experience of this condition?

Cheers

Mike

[peterpeter]

TedMaul said:

Just had a letter from the hospital post diabetic screening. It says I have diabetic maculopathy.

Firstly, I am very angry with the hospital consultants as everything in the leaflet provided, pretty much describes word for word what I have described to them. The word doc I wrote describing my symptoms could have been used instead of the leaflet, they are that similar.

Secondly, everything I have read says gliclazones make it worse. I started on these a month or two before my symptoms started. This was put down to a coincidence, which 15 mins on google suggests otherwise

Thirdly I'm really quite anxious. Not bothered by laser eye surgey, but the fact it is a degenerative condition and it could get worse. Huw/911 have you any experience of this condition?

Cheers

Mike

968 here logging in on peterpeters account.

One thing to make clear, the intraocular pressure has nothing at all to do with the fluctuation in your vision caused by diabetic maculopathy.

Secondly, diabetic maculopathy is common in type 2 diabetics and the best treatment is to strictly control your diabetes, your HBA1c should be less than 7% and your blood pressure under tight control. You should be on an ACE inhibitor for your blood pressure, as that has positive effects in limiting the development of maculopathy.

Your first post does sound, on the face of it to have described diabetic macular oedema, however, if you had the full plethora of investigations, and there was no leakage or thickening of your retina, it wasn't there. If you did have the investigations and they didn't pick it up, then that's a bit sad. Not sure about gliclazides and worsening retinopathy. I've seen loads of patients with these meds and seldom noticed their eye signs getting worse.

If your control remains tight, then it may not degenerate and frankly it might actually improve. Try not to be anxious, particularly if you're good at keeping your control tight. For anymore info pm me (968 that is).

Sorry I didn't see your post a month ago. I don't come to this webpage much these days, as it's gone sadly downhill over the past year.

[HUW JONES]

Hi Mike,
968 is right.Sorry you feel let down by your medical advisers.
ATB,
Huw

[TedMaul]

peterpeter said:

TedMaul said:

Just had a letter from the hospital post diabetic screening. It says I have diabetic maculopathy.

Firstly, I am very angry with the hospital consultants as everything in the leaflet provided, pretty much describes word for word what I have described to them. The word doc I wrote describing my symptoms could have been used instead of the leaflet, they are that similar.

Secondly, everything I have read says gliclazones make it worse. I started on these a month or two before my symptoms started. This was put down to a coincidence, which 15 mins on google suggests otherwise

Thirdly I'm really quite anxious. Not bothered by laser eye surgey, but the fact it is a degenerative condition and it could get worse. Huw/911 have you any experience of this condition?

Cheers

Mike

968 here logging in on peterpeters account.

One thing to make clear, the intraocular pressure has nothing at all to do with the fluctuation in your vision caused by diabetic maculopathy.

Secondly, diabetic maculopathy is common in type 2 diabetics and the best treatment is to strictly control your diabetes, your HBA1c should be less than 7% and your blood pressure under tight control. You should be on an ACE inhibitor for your blood pressure, as that has positive effects in limiting the development of maculopathy.

Your first post does sound, on the face of it to have described diabetic macular oedema, however, if you had the full plethora of investigations, and there was no leakage or thickening of your retina, it wasn't there. If you did have the investigations and they didn't pick it up, then that's a bit sad. Not sure about gliclazides and worsening retinopathy. I've seen loads of patients with these meds and seldom noticed their eye signs getting worse.

If your control remains tight, then it may not degenerate and frankly it might actually improve. Try not to be anxious, particularly if you're good at keeping your control tight. For anymore info pm me (968 that is).

Sorry I didn't see your post a month ago. I don't come to this webpage much these days, as it's gone sadly downhill over the past year.

Thanks for the info, both of you!. They did mention microvascular anurisms last year, but said that they weren't serious, so maybe they thought I had the onset, but not serious enough to warrant any laser surgery.

Am seeing GP wed to talk about ACE inhibitor as blood pressure is slightly high and have appointment with eye consultant a week on Thursday at Sheffield Hosp. Ironically, my eye feels much better today than it has done for weeks for some reason!

Comments about blood sugar and pressure noted and seriously considering a lifestyle change, less stressful job, with opportunities for excercise and more 'me' time rather than working here and at home for 14 hours a day!

Cheers guys, info appreciated as always!

Mike

[968]

TedMaul said:

Thanks for the info, both of you!. They did mention microvascular anurisms last year, but said that they weren't serious, so maybe they thought I had the onset, but not serious enough to warrant any laser surgery.

On their own microaneuryms are not an indication for laser treatment. It's only if there is evidence of leakage under the macula that laser might be carried out in non-proliferative diabetic retinopathy.

TedMaul said:

Am seeing GP wed to talk about ACE inhibitor as blood pressure is slightly high and have appointment with eye consultant a week on Thursday at Sheffield Hosp. Ironically, my eye feels much better today than it has done for weeks for some reason!

Comments about blood sugar and pressure noted and seriously considering a lifestyle change, less stressful job, with opportunities for excercise and more 'me' time rather than working here and at home for 14 hours a day!

Cheers guys, info appreciated as always!

Mike

Good. An ACE inhibitor has been proven to be of significant advantage in cases of diabetic retinopathy. If you can tolerate it and you have no kidney problems, then I think that would be a good option. Also consider getting your cholesterol under tight control also. You might need to take a statin if that isn't controlled. Certainly lifestyle changes are important. Doing exercise and eating healthily is vital. I think the diabetic doctors have access to dieticians and other lifestyle support professionals who can advise how to balance a busy professional life with being diabetic and keeping things under tight control.

[TedMaul]

968 said:

TedMaul said:

Thanks for the info, both of you!. They did mention microvascular anurisms last year, but said that they weren't serious, so maybe they thought I had the onset, but not serious enough to warrant any laser surgery.

On their own microaneuryms are not an indication for laser treatment. It's only if there is evidence of leakage under the macula that laser might be carried out in non-proliferative diabetic retinopathy.

TedMaul said:

Am seeing GP wed to talk about ACE inhibitor as blood pressure is slightly high and have appointment with eye consultant a week on Thursday at Sheffield Hosp. Ironically, my eye feels much better today than it has done for weeks for some reason!

Comments about blood sugar and pressure noted and seriously considering a lifestyle change, less stressful job, with opportunities for excercise and more 'me' time rather than working here and at home for 14 hours a day!

Cheers guys, info appreciated as always!

Mike

Good. An ACE inhibitor has been proven to be of significant advantage in cases of diabetic retinopathy. If you can tolerate it and you have no kidney problems, then I think that would be a good option. Also consider getting your cholesterol under tight control also. You might need to take a statin if that isn't controlled. Certainly lifestyle changes are important. Doing exercise and eating healthily is vital. I think the diabetic doctors have access to dieticians and other lifestyle support professionals who can advise how to balance a busy professional life with being diabetic and keeping things under tight control.

I'm on simvastatin already and it reduced levels from about 6.6 to 3.8 and it has stayed at that level for a couple of years. Hospital dieticians are very hard to get hold of, but had help from a PHers O/H who is a dietician. Main problem is weight has ballooned over last 2 years, lack of excercise and time to do so with two small kids. Have gone from 11.5 to 13.5 stone, BMI is now 29.7 which is way off the mark. I think I know what I have to do, surgery or no surgery, just not going to be easy!! Mind you, I gave up smoking a few years ago and that was the hardest thing i ever did. Getting back on my MTB (which I love) should be a piece of **** in comparison!!!

Cheers All

Mike

[968]

TedMaul said:

I'm on simvastatin already and it reduced levels from about 6.6 to 3.8 and it has stayed at that level for a couple of years. Hospital dieticians are very hard to get hold of, but had help from a PHers O/H who is a dietician. Main problem is weight has ballooned over last 2 years, lack of excercise and time to do so with two small kids. Have gone from 11.5 to 13.5 stone, BMI is now 29.7 which is way off the mark. I think I know what I have to do, surgery or no surgery, just not going to be easy!! Mind you, I gave up smoking a few years ago and that was the hardest thing i ever did. Getting back on my MTB (which I love) should be a piece of **** in comparison!!!

Cheers All

Mike

Sounds like you're making the right changes. You certainly seem aware and have insight into your situation, and in my experience that counts for a lot because people seem to be in a state of self-delusion often, and it's tough when I look into their eyes and say, 'you need laser or else you might lose your vision altogether' they are often dumbfounded, but deep down they seem to know.

What I often say is, you're probably relatively young, and have a family, and all the changes you make now, will mean that you will have good vision and a good lifestyle and quality of life, when you're middle aged and indeed when you get old. Avoiding the changes required will mean the possibility of a life terribly inhibited by disability either to your eyes or poor mobility from diabetic neuropathy and peripheral vascular disease. It is a bit of grimness to talk in such terms, but sometimes I think people need to be confronted with reality, in order to make the changes that they need to ensure a good and healthy life. These changes aren't easy to make, but then the consequences are also not easy on the individual.

Definitely get your GP to see if he can help you in anyway to get your weight down and see if he has access to any dieticians and lifestyle groups that specifically cater for diabetics. In Manchester, where I work, we certainly have programs available for people to access advice and education. These are aimed at younger people and busy professionals, who often sacrifice their control, for the sake of their work patterns.

[TedMaul]

968 said:

busy professionals, who often sacrifice their control, for the sake of their work patterns.

Well thats me through and through. 12 hour work days, a 4 year old son and a two year old daughter! Once eldest gets the plaster cast off his arm (another thread in itself) he can have the bike I bought him for his 4th birthday and we can both get out and get some excercise! Just need to do some thinking re the troublesome work/life balance. Will go on holiday post appt and work it all out then methinks

Thanks once again

[TedMaul]

Saw consultant yesterday. Says the area of leakage has not deteriorated significantly in the last year and if anything, is drying slightly and is fractionally better. No surgery needed at this time, though I will be recalled for a check up in four months.

Bit deflated as I had set myself up for arranging laser surgery and now it feels like I have to wait..... and wait..... but its good news really I guess.

He had some interesting views on the letter I received warning me of maculopathy, suggesting that it was being used as a default letter these days to sort of 'scaring' people into attending the referral from the screening programme, rather than the previous tame ' please come in and see us' version. Apparently it is having a good effect though with a greater percentage of people attending their appointment, which I guess can only be a good thing.

[TedMaul]

Hmmm and now been offered opportunity of a promotion. Bit more money, very, very good job security. Bit more stress and agg though until I get the team settled.... decisons, decisions..... A weeks holiday to think about it.....

Edited by TedMaul on Thursday 18th June 17:08

[968]

TedMaul said:

Hmmm and now been offered opportunity of a promotion. Bit more money, very, very good job security. Bit more stress and agg though until I get the team settled.... decisons, decisions..... A weeks holiday to think about it.....

Edited by TedMaul on Thursday 18th June 17:08

Good news! You can do it. Being diabetic shouldn't preclude you from this. Get the lifestyle adjustments sorted and you will be fine. It's probably your good control that has improved the macula

[TedMaul]

Sorry for thread resurrect but eye is very bad once again. On advice from diabetic clinoc have stopped taking piaglicglazone and replaced with Stitagliptin. Sugars seem better controlled but eye is really terrible. Due back at eye clinic in couple of weeks - anything I can ask them to look at?

[968]

TedMaul said:

Sorry for thread resurrect but eye is very bad once again. On advice from diabetic clinoc have stopped taking piaglicglazone and replaced with Stitagliptin. Sugars seem better controlled but eye is really terrible. Due back at eye clinic in couple of weeks - anything I can ask them to look at?

Sorry for late reply, PH has deteriorated in it's content recently, with some frankly disgraceful posters so I don't come here that often. Better to email me.

They need to look at your macula. Make sure there is no swelling or waterlogging in the macular area, and if there is, consider some more laser treatment to encourage the fluid to dissipate. They might want to do some tests in the form of a fluoroscein angiogram, to investigate the circulation of your retina and also an OCT scan, both these tests may provide some information as to whether you'll benefit from laser, or other possible therapies. Make sure you know your HbA1C % and also that your BP is controlled....

Edited by 968 on Monday 7th September 00:27

[TedMaul]

968 said:

TedMaul said:

Sorry for thread resurrect but eye is very bad once again. On advice from diabetic clinoc have stopped taking piaglicglazone and replaced with Stitagliptin. Sugars seem better controlled but eye is really terrible. Due back at eye clinic in couple of weeks - anything I can ask them to look at?

Sorry for late reply, PH has deteriorated in it's content recently, with some frankly disgraceful posters so I don't come here that often. Better to email me.

They need to look at your macula. Make sure there is no swelling or waterlogging in the macular area, and if there is, consider some more laser treatment to encourage the fluid to dissipate. They might want to do some tests in the form of a fluoroscein angiogram, to investigate the circulation of your retina and also an OCT scan, both these tests may provide some information as to whether you'll benefit from laser, or other possible therapies. Make sure you know your HbA1C % and also that your BP is controlled....

Edited by 968 on Monday 7th September 00:27

No problem! Thanks for the info, much appreciated and will ask accordingly. hba1c is 7.3, was 7.2 and 7.1 6 and 12 months ago so is ok and am losing weight at a steady if unspectacular pace.

Started new job today (and yes on PH already) and think stress/nerves/bp may be playing a part more than I let myself believe maybe. Should be back at eye hospital end of month and have diabetic clinic on 24th

Thanks once again for the advice

Mike

[968]

TedMaul said:

968 said:

TedMaul said:

Sorry for thread resurrect but eye is very bad once again. On advice from diabetic clinoc have stopped taking piaglicglazone and replaced with Stitagliptin. Sugars seem better controlled but eye is really terrible. Due back at eye clinic in couple of weeks - anything I can ask them to look at?

Sorry for late reply, PH has deteriorated in it's content recently, with some frankly disgraceful posters so I don't come here that often. Better to email me.

They need to look at your macula. Make sure there is no swelling or waterlogging in the macular area, and if there is, consider some more laser treatment to encourage the fluid to dissipate. They might want to do some tests in the form of a fluoroscein angiogram, to investigate the circulation of your retina and also an OCT scan, both these tests may provide some information as to whether you'll benefit from laser, or other possible therapies. Make sure you know your HbA1C % and also that your BP is controlled....

Edited by 968 on Monday 7th September 00:27

No problem! Thanks for the info, much appreciated and will ask accordingly. hba1c is 7.3, was 7.2 and 7.1 6 and 12 months ago so is ok and am losing weight at a steady if unspectacular pace.

Started new job today (and yes on PH already) and think stress/nerves/bp may be playing a part more than I let myself believe maybe. Should be back at eye hospital end of month and have diabetic clinic on 24th

Thanks once again for the advice

Mike

That HBA1C is pretty good, I'm sure stress is playing a part, but if the blurred vision persists, then do at least go to your regular optometrist and get them to check your prescription and perhaps take a picture of your macula.