Eye photos

I used to have my eyes checked by the diabetic clinic at the hospital. They would photograph them regularly and explain the photos and any changes. A while back they referred me to the main hospital eye department. I have now not had my eyes photographed for over 18 months which really worries me. I questioned this at my last appointment and was told it was normal for a doctor to just look at my eyes and not photograph them. What does DAFNE reccomend about eye photos? Are they necessary? Are my doctors right not to take them? It worries me because I think a machine would be more accurate than a person. And if a photo was taken then any changes could be explained to me and also give the option of second opinions from other doctors. If it is just a doctor looking, then that cuts me out of my own care which is surely against DAFNE principles. I need to be able to see any physical impact or changes which are occurring either to be able to feel proud of improved control or to motivate myself to do better. I am simply not happy with not having photos. Who should I complain to and what should I do?

Hi Lizzie
When it comes to photos, the research evidence shows that they are better at picking up early and important changes than GPs and even diabetes specialists. However, eye specialists are going to be better than photos which is probably why you were referred. As long as it is a specialist that is checking your eyes you are receiving the right treatment. Sometimes, the specialist arranges special photos involving an injection to cause florescence of the blood vessels but this doesn't seem to have happened in your case. If you are brave enough then you could ask your specialist if you can have photos and he/she might listen. DAFNE doesn't have a policy about photos although the national picture means that everyone with diabetes should now be having photos unless they get referred to an eye specialist.
Simon

Hi Lizzie, I've just had photos done at the request of the local healthcare trust. However it seems unrelated to the Eye Infirmary consultant I see every year, nor my GP, nor my diabetic clinic.
Furthermore the feedback letter from the local healthcare trust says some slight 'changes' were detected, but not if good or bad, and what is most shocking is that this was the first time they have done such photos, so how on earth do they detect any changes. I found it upsetting and prefer to talk to the consultant at my eye infirmary who tells me there and then what he has seen.
My local healthcare trust relies on local opticians having the right equipment to take the photos but to be honest I don't trust local opticians, especially when it's not my own, to get it right. Why can't the diabetic clinic have this equipment and talk to me at the clinic about the photo they could take there and then?

John,
What do you mean by the eye infirmary ? Are they linked to your diabetes clinic ? It sounds like the local trust is doing its own independent standalone system that as your say sounds VERY badly run. A letter saying you have slight changes is totally unacceptable without any details of what this means and a chance to disuss it with someone. I wouldn't be happy with an optician checking my eyes either.

In kent we have a very good eye service provided to the PCT by the local Diabetes Charity. It is staffed by Diabetic Eye specialists and has a number of mobile eye screening vans that visit GP's. When ever I have my eyes done, I have a chat with the person doing it and they show me the pictures on screen and explain what they are seeing. The pictures are still checked back at base and I get a letter about it, but I
do get chance to understand what the pictures mean. I am lucky I guess.

I would suggest that if you are concerned you call the Diabetes UK Careline. We had a presentation last week from Diabetes UK on what
care to expect and I know this is an area they are concerned about and will be interested to hear about the 'service' you are receiving.

I am pretty sure that any eye photos requested by the PCT and taken by local opticians are supervised by the eye specialists as this is govt policy. However the point about the lack of explanations and the anxiety raised by 'slight changes' is important and should be dealt with. In Sheffield the local specialist teams can access both the photos and the report and discuss them at a clinic visit. I would ask the people at the Diabetic clinic to try and get hold of these so you can have a proper explanation. Ideally you should be able to look at the photos together and have them explained.
Simon H

Marke, the eye infirmary is literally that, a hospital that does nothing but eyes. I have no criticism of the eye infirmary whatsoever and if anyone gets the chance to have their eye care at such a hospital I can fully recommend it.
I am not concerned, other than to have wasted my time and NHS money getting the photos at the optician.