HI all,
l started Plaquenil a few weeks ago, and l am going to Specsavers for an eye test today. It has suddenly occurred to me that a high st optician might not be the correct place to book an appointment. Should l be seeing an eye specialist via a GP referral or is a normal opticians okay to use to check for Plaquenil toxicity?
i had my baseline texted at my local hospital
some opticians can do this also but you will have to pay
NHS free to check
Good luck
lol! Part of my reasoning behind all this pondering this morning is the idea of spending £30.00 or so on an enhanced eye test, and then find out later l had effectivelybeen 'robbed' because of the need to have one done that could only be done in a larger, more specialised setting.
any amount is worth it, I think. I had both done, hospital and high street. It appears that they are no longer providing a baseline free on the NHS I believe. And, they are no longer screening at 5 year intervals. I think we are on our own.
When you go to Specsavers, make sure you get an OCT scan as well as the standard test and explain that you take hydroxychloroquine for lupus. You need to get this done annually.
I had an emergency scan at Specsavers on Friday and he explained that we should all be getting a hospital test using a fluorescein dye along with the OCT scan - I think after 5 years on HCQ. But the hospitals are extremely busy. Opticians are much more up to speed on all this than many doctors, including at my last rheumatology appointment!
I found out I don't have HCQ-induced retinopathy, but have a macular hole, most likely age-related. Apparently it can be treated with surgery, which is a pretty scary prospect.
This does alleviate my concerns so many thanks for explaining it all. I have not had a good time with opticiansin the past so l will find any excuse not to go. 😁
i had a jumped up little chap from Moorfields discharge me! Really best eye hospital in the world you have to laugh at times at the inadequacies
Contact the MECS service
primaryeyecare.co.uk/servic...
It is an NHS service - and they have all the equipment required for your monitoring, more than many hospitals have, and without the long waits to see a doctor at the hospital. They will refer anything that needs it.
thanks for that. I typed in my postcode and the one l am going to is on the list.👍
Retinopathy whatever the cause is a serious eye condition!
MECS, the NHS “Minor eye conditions service” may not be suitable?
They look for the signs - they have the equipment are are easily accessible. The emergency service is always accessible. Having identified the signs - you are immediately referred to the eye specialists. As you so rightly say, GPs can't identify problems, they have no equipment to do so. That is why the service is provided by specified optometrists. But they don't treat.
The only way to detect retinopathy is by an OCT (Optical coherence tomography) scan machine:
aao.org/eye-health/treatmen...
Not a simple eyesight test!
Retinopathy is often symptomless unless serious.
Ophthalmologists (medically trained eye doctors) are different to opticians!
feelgoodcontacts.com/eye-ca...
I am quite aware what optometrists do - but the equipment they have when they are part of the MECS system is far ahead of a simple sight test as used by an optician who merely dispenses glasses. They are contracted by the NHS to provide the first stage of diagnosis and have advanced equipment.
"Standard eye exams won’t detect diabetic retinopathy but an optician will be able to pick up on any suspicious activity and refer you on toy an ophthalmologist or optometrist can detect it. The NEI recommends an annual dilated exam for:
Those who are 60 or older
Ethnic minorities after age 40 due to their higher incidence of glaucoma
People who are diabetic"
davidpaulopticians.co.uk/ho...
I was having such examinations by my optician well over 20 years ago. He had wanted to learn "how vision worked" and was advised to study as an optometrist rather than doing medicine. He then continued to do a PhD and ongoing research until he realised all his peers were earning far more. He set up his own business and bought all the toys. He was years ahead of the curve - but most large opticians now are able to provide such screening.
primaryeyecare.co.uk/about/...
It’s actually a private business that provides NHS services! Not the same thing.
Have you not seen how many NHS services are now bought in from private companies? It doesn't make them any less able and some are staffed by previous NHS staff. My daughter, an endoscopy specialist nurse, works most weekends for a private company who are trying to deal with the waiting lists. All the staff are either current or former NHS staff - especially the doctors. Many GP groups are privately run and the NHS has operations done in private hospital. It doesn't make it right - but that is what is being done to the NHS.
I have my eyes checked yearly by the hospital. It was recommended after quite a few years on HCQ. It was the 1 service I saw through lockdown ! I also have my eyes tested yearly at an Opticians. No problems as
I probably should have mentioned at the start that l don't have Lupus, l have systemic sclerosis. I posted here because those with Lupus seem to rise earlier than those over on the Raynaurd's and Scleroderma forum! l was an hour away from being at the opticians and looking for some quick replies.
l went anyway and found it all a bit odd. Two opticians there. The scan bit was done twice as the first optician didn't scan the back, only the front of my eyes. Aside from letting them know about the ssc and plaquenil, I also let the optician know my mum has anca related vasculitis and that l am also ANCA positive, but she had never heard of it. I thought l had better let her know because l keep getting eye pain in my left eye. Feels like a pulled muscle. She said there was pressure in my left eye, but that it was okay when tested again.
she is writing to my GP so that is reassuring at least.
Thanks for all your replies. They have been really helpful.
👍
my lupus nurse said to go to a high street optician was fine but she said the Drs like you to have the oct scan which costs about £10 ( at the optician I use not everywhere does it though) it checks the retinal depth and where the optic nerve joins it’s actually quite interesting to see the scan results. You need to get tested once a year if you’re on hydroxychloroquine I was told which is what I have always done. Make sure you tell them you’re on hydroxychloroquine when you see the optician.
SS will refer you on to a NHS ophthalmologist if they deem it necessary.In my experience they refer you on quicker than a GP as they only deal with eyes.
as long as you get a retinal scan done it will be fine. I go to an high st optician but they do full eye checks, lining widths etc. only £20 more.
The American Academy of Ophthalmology suggests ophthalmologists regularly check their patients for Plaquenil toxicity with photos and the following tests:
--a visual field test to check if blind spots have developed in the field of visionOCT imaging
--a three-dimensional image taken to look for early retinal damagea multifocal ERG test to see how retinal cells respond to light and to check for damage
I see an opticians on the high street and pay for the picture from the back of the eye
I think the eye clinic are too busy these days but maybe worthwhile asking
I have a card too so I can check my vision
I live in the US and go for these tests every 6 months at my ophthalmologist’s office. Thankfully they are paid for by insurance after the $20 copay. If my rheumatologist doesn’t send a letter stating my eyes don’t show plaquenil issues, he won’t renew the prescription. I don’t take any chances with my vision.
Had mine done at Specsavers and at hospital, the hospital one was more thorough, Specsavers was quicker but yields the same results.....both courtesy of the NHS.
Which bit of their purpose escapes you? They screen - and according to the info I saw on the NHS site, they do a full pupil dilation examination to look for signs. Almost all optometrists do that these days,
Hi PMRpro,
I have read Betty909090’s posts very carefully and you seem to have avoided her question about the OCT scanning equipment for analysing the retina and its layers very thoroughly. It is not a “toy” as you insinuate?🧐
Retinopathy can be very serious and leads to blindness.
Regards
I did not insinuate it is a toy - I said my optician bought a lot of "toys" which is what HE referred to them as, but they all had a very serious purpose. I am quite aware of how serious retinopathy is.
I also said the place to start is with MECS who do have most of the equipment required, some have all of it. GPs are of no use at all but an optometrist in the scheme CAN examine the back of the eyes and see damage. They then refer the patient to the eye clinic - as an emergency as appropriate. You will get direction immediately - which is surely preferable to NO direction, which is quite likely since in the early stages there may be no symptoms. And given the state of the NHS currently, there is likely to be a VERY long wait for a routine appointment for a new patient.
”an optometrist in the scheme CAN examine the back of the eyes and see damage. ..”
====
If the optometrist has an up to date digital OCT scanning machine in his practice why would he need to refer the patient to the eye clinic for yet another scan.
He will be able to see all the layers of the retina as digital photos and could email them to the other eye clinic for a second opinion?
IF laser treatment is required for the retinopathy couldn’t this optometrist also provide it?
You must see an ophthalmologist, not an optician.
The ophthalmologist will give you the “Peripheral vision test” and other tests that will check for toxicity.
So a regular optician with just a “vision check” is not the right way- you are correct💜😊💜
my gen hospital, calls me in once a year for these tests xx
hi Blue-feather. I live in Edinburgh and neither my rheumatologist or my GP referred me to an ophthalmologist when I got prescribed HCQ and I asked my optician to referred me but he said they can do all the necessary tests. I went back after having problems a month later with dry eyes but it was mostly because the weather was too hot this year and I work with two computer screens. My optician said that they don’t refer any more to ophthalmologist for this check ups and I think the NHS ophthalmologist are very busy like everything else in the NHS. My optician did scans of my eyes and check any degeneration of my macula, so I think now many opticians are doing it
I see an Ophthalmologists at the hospital every 6 months. My Lupus consultant arranged this once I started taking Hydroxychloroquine a few years back.
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