Monthly Archives: October 2017

Don’t pretend to be a stupid person!

If you read my last blog post, ‘Hunt the optometrist: round 4‘, you’ll know that I went for my ‘normal’ eye test a couple of weeks ago.  I use the word ‘normal’ loosely, as sadly my pesky peepers will never again fit into that longed-for category.  So fearful was I that the optometrist might find something wrong that I booked the very first eye test appointment of the day, just to ensure that I had time to hot-foot it up to Moorfields on the train if necessary.  But I digress…

The reason I’m writing today’s blog post is not to talk about my own eye test, but yours, dear reader.  Yes… yours!  When did you last have an eye test?  Normally (there’s that word again), people are advised to have one every two years.  That includes children, in case you’re wondering.  In fact, it’s particularly important for children to get their eyes tested regularly, as they may not be aware of what ‘normal’ (aaarrggh!) vision should look like, and any visual problems are likely to affect their educational development.  It can be tricky keeping up at school with waffy vision.  A standard eye test will take approximately 30 minutes every couple of years – that’s really not much of a commitment to make in order to look after your vision, is it?  If you’re in the UK, you can even find vouchers for free eye tests – just Google ‘free eye test vouchers’.

Since my eye problems began, I’ve been keen to nag harass threaten encourage people to realise the importance of taking care of their eyes by going for regular eye tests.  Of course, the main reason for my concern is that if more people do this, any problems are likely to be picked up far more quickly and hence there won’t be even more people clogging up the already packed hospital eye clinics.  This will be a huge plus for myself and my long-suffering eye buddies.  But apart from that, here are a few more reasons why regular eye tests are so important:

  • Some eye conditions don’t have any obvious symptoms and can progress very gradually – for example glaucoma, macular degeneration, and cataracts.  An eye test can pick up early signs of sight-threatening conditions such as these, so that they can be treated swiftly, allowing a better chance of a successful resolution.
  • Other health conditions – for example diabetes – can be detected as a result of an eye test.  Again, once diagnosed, people can get treatment more quickly.
  • Often people don’t realise that they need glasses or contact lenses because changes in eyesight can occur very gradually and people just assume that as they get older their eyesight will get worse.  By having an eye test and sorting out any problems, people can improve their vision and therefore their quality of life.  Why peer and squint if you don’t have to?!
  • With the above in mind, it’s particularly important for people who drive to get their eyesight checked regularly, to ensure that they meet the requirements for driving.
  • Eyes are the second most complex organ in the human body, after the brain, and you only get one pair.  Treat them with respect.
  • Finally, a frightening statistic from the International Agency for the Prevention of Blindness: 80% of blind people in the world are avoidably so.  Don’t find yourself contributing towards that statistic!

Faced with all that, why on earth do people not just ruddy well go and get their eyes tested regularly?  I’m not entirely sure, but I think the main reasons are: misplaced confidence (i.e. “My eyesight is great; I don’t need an eye test!”); fear of having to wear glasses as it’s often associated with getting older; or just plain laziness.  Regarding the first reason – if that’s the case, then go and get it checked and then you can gloat freely about having perfect eyesight.  Concerning the second reason – your vision is far more important than your vanity: get a grip.  As for the third reason – pffft, I have no time for laziness!

It frustrates me when people appear to be so blase about their sight, and when family or friends treat their eyes so casually I actually find myself getting genuinely upset about it.  It’s a tricky one, because of course I don’t want to hassle people, and there’s only so much I can do on the encouragement front.  I thought I’d cracked it with a certain person a few weeks ago by casually presenting her with a voucher for a free eye test, which I’d been given.  This is someone who confessed to me some time ago that she hadn’t had an eye test since she was a child and when faced with my dropped jaw, she’d insisted that her sight was excellent and therefore she didn’t need a test.  I was even more dismayed the other day when I mentioned the voucher and she replied that she might not use it after all!  Horses and water sprang to mind and it was clear that there wasn’t much point in reitterating all the benefits of having regular eye tests.  Instead, I stifled a frustrated groan, sighed a huge internal sigh of disappointment, and pointed out only half-jokily, “But you’re an intelligent person!  Don’t pretend to be a stupid person – get an eye test!”  I’m not sure whether she will, but I did ask her to pass the voucher on to someone else if she doesn’t intend using it herself.

I shall end this post with a plea directly to you, dear reader.  Yes… YOU!  Now, clearly you’re pretty intelligent, wouldn’t you agree?  Have you had an eye test in the past couple of years?  If not, please go and get it sorted.  Don’t pretend to be a stupid person.

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Hunt the optometrist: round 4

As the day of my annual ‘normal’ eye examination loomed, I decided to continue my quest to find a decent optometrist in Canterbury.  Now, before going any further here, let me explain that I’m talking about what most people refer to as an optician, for a standard eye test.  However, if we want to be accurate about things (and, trust me, I usually do), an optician is actually the person who makes and fits glasses and contact lenses.  An optometrist carries out eye tests, prescribes corrective lenses, and is qualified to diagnose certain eye abnormalities and diseases and prescribe medication for them or refer for further treatment.  An ophthalmologist is a medical doctor who specialises in eyes and is qualified to practice medicine and surgery.

After my first retinal detachment, I stopped going to the high street optometrists I’d been visiting for years, because I realised that they hadn’t given me the correct information about floaters.  (See ‘How it all began‘ if you’re wondering what they told me and why it was wrong.)  If they’d given me the correct advice, it’s possible that things may have been very different for me.  I then began using another popular high street optometrist, until I was informed one day upon going in for a quick eye pressure check, as I’d been doing sporadically for the past year or so, that they could no longer do this.  In my attempts to discover the reason for their abrupt policy change, I became involved in several heated discussions in which they told me that a) the hospital should be doing the pressure checks and was just ‘fobbing off’ their work; and b) as my eyes had so many problems, I might sue them if they got the pressure readings wrong.  Needless to say, my blood was boiling by this point and I vowed never to darken their door again.  In contrast to their customary advertising campaign, I think this behaviour demonstrates precisely why people shouldn’t go to this particular optometrists.

On my next visit to an optometrist, I plumped for an independent one (as detailed in ‘Post appointment panic‘).  Apart from the fact that he reminded me of John Major and had a sense of humour (or lack, thereof) to match, this grey-faced chap put me off by trying to tell me that it was possible to see enough of the retina to check it properly without using dilation drops.  I know that this simply isn’t true – not when checking for tears, anyway.

So it was after extensive research that I set off early on Saturday morning to another carefully selected independent optometrist, to put them through their paces for my eye test.  It started well, as I was greeted by a smiling receptionist and then a polite fellow who bore no resemblance to any politician I can think of.  He began the appointment by asking cheerfully, “So, is everything okay with your eyes then?”  I shifted uncomfortably in the chair as I responded almost guiltily, “Err… no, not exactly.  I’ve had multiple retinal detachments in my right eye, and I’ve got PVR.  I’ve got silicone oil in there at the moment.”  He looked slightly taken aback at this, and went on to ask about my left eye.  “It had two retinal tears which were fixed with cryotherapy and I have a cataract and lots of floaters”, I told him.  He shook his head in sympathy and told me how unlucky I was to have so many problems in both eyes, before asking with a slightly incredulous undertone, “Is there anything else?”  I completely forgot to tell him about the lattice degeneration, although that came up later, and the abnormal blood vessels, and just replied that I hoped that was enough for now, at which he nodded in agreement.

He carried on with the usual business of the eye test, and when we reached the pressure check, we had an interesting discussion about high pressure.  Much to my delight, he told me that he’d be happy to check my eye pressure if necessary, between my appointments at Moorfields.  He even told me that he’d be happy to dilate my eyes and check for tears if I wanted him to, at which point I almost toppled off the chair in shock.  Previous optometrists have been all but backing away from me by this point!  This one told me that he loves dilating because it allows the opportunity to get a proper look at the back of the eye, which he finds really interesting!  He did, however, also say that it was only necessary for him to dilate if there were symptoms suggestive of a retinal tear or detachment: i.e. showers of floaters, flashing lights, or the much-feared ‘curtain’.

He went on to do a spot of digital retinal photography and was happy to show me the images and explain various things.  It was somewhat depressing to see the image of my right retina, which bore certain similarities to a teenager’s bedroom,  but at least the left one looked far more clean and tidy.  He also checked for dry eye.  As he asked me to look up while he put the drops in, I asked what they would do.  “They’ll make all your problems disappear”, he joked, with an air of mystery.  I imagined my future – bright and colourful, with 6/6 vision and no more worries – and told him that he’d be my hero forever if the drops did that.  He clearly decided that his pants wouldn’t look very professional worn over his trousers, as when I’d blinked the drops away, my view of the world was just the same.  Or, almost the same… for I finally seemed to have found a decent local optometrist.  Perhaps he’ll work on those magic drops ready for my next visit…

I’m not an ophthalmologist, but…

… when one of my work colleagues rang me on a Monday evening a couple of weeks ago to ask my opinion about odd things going on in her eye, I thought I knew what the problem was.  She told me that she’d just got back from dog-walking the previous day when she saw white flashes down the left side of one eye.  She’d also seen two big floaters, squiggly lines, and tiny dots.

I began to feel slightly sick as she described all this and quickly asked her whether she’d noticed any loss of vision or a ‘curtain’ coming across.  “No, I don’t think so”, she said, before asking what I meant by a curtain.  “It’s literally like a black curtain being drawn across the inside of your eye which you can’t see through; or like a shadow obstructing your vision”, I explained.  She was reassuringly certain that she couldn’t see anything like this and then went on to tell me that she’d been to the doctor’s about it late the previous afternoon.  “What did the doctor say?”, I asked, knowing very well that what he should have said was get to an eye clinic at a hospital or to an optician’s PDQ to get it checked out.  But no.  Apparently he just had a look in her eyes, commented that the blood vessels looked healthy and suggested that she pop to the opticians, with no sense of urgency whatsoever, although he did casually mention that it could be a retinal detachment.  “Whaaaaat?!”, I spluttered in response.  “Well, it’s no good just looking at the front of your eye – he needs to look at the back of it, and he can’t do that without dilating the pupil and carrying out a proper examination with the correct equipment!”  As far as I know, GPs don’t have the expertise to do any of this, which is why he should have referred her urgently.  You shouldn’t muck about with symptoms of retinal detachment, as I know very well!  Oh, and he also took her blood pressure, which is unrelated to eye pressure and has absolutely no bearing on a suspected retinal detachment.  Genius…

“Do you think it’s a retinal detachment, then?”, she asked me.  “Well, it sounds like PVD to me”, I answered cautiously, to which she enquired nervously, “What’s PVD?”  I explained that PVD means posterior vitreous detachment and isn’t the same thing as retinal detachment.  PVD occurs when changes to the vitreous fluid in the eye mean that it shrinks and pulls away from the retina at the back of the eye.  These changes happen as part of the natural ageing process but sometimes if the vitreous starts to pull away from the retina, it can cause flashes and floaters as it does so.  As it pulls away, it can also occasionally result in a retinal tear, which can then lead to a retinal detachment.  As any regular readers of my blog should know by now, retinal detachment is a medical emergency which requires surgery to fix.  Unfortunately, as well as being symptoms of PVD, flashes and floaters are also symptoms of  a retinal tear or detachment.

“So what do you think I should do?”, she asked, “Shall I come to work tomorrow and try and get an appointment with the optician?”  “NOOO!”, I almost shrieked in alarm.  “Definitely don’t come to work – you need to get it checked out first!”  Realising that I may have been worrying her further, I tried to stay calm and advised her to get to an optician’s first thing in the morning, and if they wouldn’t look at it then to go straight to the closest decent hospital eye clinic.  “They’ll need to dilate your pupil to have a proper look at the back of your eye.  Don’t let them fob you off by saying they don’t need to dilate!”, I instructed her urgently, all too aware that a certain optician in Canterbury had tried to tell me that he could see enough of  my retina without dilating my eyes.  “How will they dilate my eyes?”, she asked, to which I replied breezily, “Oh, don’t worry – they’ll just put drops in.”  “Oh no!”, she gasped, explaining that she wasn’t very good at having anything near her eyes.  I paused, reflecting that this probably wasn’t the time to tell her that the drops sting quite a lot.  After promising to let me know how she got on, we hung up and I went off to bed wondering if I should have explained about what to do in terms of head positioning in case she did start to see a shadow…

Worry made the next morning drag, but eventually I received a text: “Eyes dilated.  She says it has done what it needs to do and should no longer be a problem but to be aware of any changes and if so go to hospital.  Your diagnosis is correct.”  Phew – it wasn’t a detachment!  The optician referred her to the hospital eye clinic for an appointment the following week, at which they dilated and checked both eyes and issued the same advice about returning if she noticed any changes.

I was hugely relieved that everything was okay, as with those symptoms it could very well have been a tear or the start of a detachment.  So, please be aware and spread the word that flashes or new floaters should be checked out urgently with an optician or hospital eye clinic.  Any loss of vision, blurring, a shadow, or a black/grey ‘curtain’ should be checked out immediately at a hospital eye clinic.  It’s worth bearing in mind that not all hospitals have eye clinics and opening hours vary so check before potentially wasting previous time on travel.

Note: You can find further information about PVD here: http://www.rnib.org.uk/eye-health/your-guide-posterior-vitreous-detachment-pvd/posterior-vitreous-detachment-PVD