I am puzzled: Since my treatment for AMD I... - Macular Society

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I am puzzled

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Since my treatment for AMD I have seen different consultants. The procedure has always been the same: vision test, dilatory eye drops, OCT, then in to see the consultant who will check both eyes (one wet one dry) with a slit lamp. For the last 2 visits I have been placed under the care yet another consultant, but here is what puzzles me:

After having gone through exactly the same procedure he then puts 2 more lots of drops in my eyes, the second seems to be a dye as my vision goes a bit yellow. He then uses a tiny, individually wrapped spatula and pushes my lower eye lids gently down, he may even touch my eyeball, but I don't feel anything and then examines my eyes again through the slit lamp. The other consultants never did that, so why now? He has never told me why or what he is looking for, or what he is finding. I will definitely ask next time I see him, which will not be until March. Has anyone else had this done? Were you given an explanation? Or perhaps you have some thoughts on it of your own? Would be interested to know.

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Hi ayayay

The only change I've had to the procedure I have, which is the same as how you describe the usual procedure you've had previously, is that I only get one set of drops for the dilation (the stinging ones) rather than two sets as I did the first few times.

It looks as if the yellow dye ones you are now getting are fluorescein:

"... drops contain a yellow dye called fluorescein, which will wash away your tears ..."

healthline.com/health/slit-...

"... may also put a few drops of dye in your eyes to highlight things she wants to look at ..."

webmd.com/eye-health/what-i...

Perhaps the ones before are just some additional "washing" ones.

As I understand it, drops are not fully necessary for the OCT – perhaps by the time we get to the slit lamp exam, the dilatory drops will have worked all they're going to and anything left on the eye surface can be flushed away. Just my guess.

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in reply to ironbrain

Thank you, ironbrain. You are right, the dye will probably highlight things. I just wish they would tell me what they are doing and why. I have never yet had a report, written or otherwise. The best they can do is to tell me occasionally: "you are doing alright" , whatever that means. You are right too in saying that dilatory drops are not necessary for an OCT. Often, before the injection, I have a VA test and then an OCT for both eyes before going in for the injection, which is for one eye only. On those occasions I do not see the consultant. Only after the OCT has been done are drops put into my eye in preparation for the injection.

By any chance does the light of the slit lamp become blue? If so i suspect this is a pressure check and/or eye surface check which is good practice.

Just ask the doctor what he/she is doing and what they are looking for. What you describe is, I believe, a visual inspection of the retina augmenting the scans you have had which tell the clinician what is happening under the surface of the retina.

I think wheezyl is right. I have the extra drops and inspection etc ( they seem to push something up against my eye) and they tell me my pressures then and if my eyes are especially dry. The inj can cause increased iop so it's good they check - that's how they caught mine way back.

A fluorescein (yellow dye) exam is usually done to check for corneal damage, abrasions or scarring. Had it done often as I wore contact lenses for 40 years

Pressure can be measured in at least 3 or 4 different ways, none of which require dye that I have seen, but all as far as I know require a well lubricated eye surface, so sometimes they put in a drop of artificial tears. I’ve had pressure measured at least a dozen times in the last month

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in reply to StokeySue

Thank you. I have (amongst other conditions) Asteroid Hyalosis in my "good"? eye, a shower of floaters spread all over my central vision. The floaters don't move to the side or sink to bottom as the floaters do in the other eye. They are always there. Maybe that is what the consultant is looking at. I will ask him next time.

Had fluorescein + slit lamp today so the surgeon could have good look at the incision made in the surface of the eye during the cataract operation and remove a stitch

He also measured the pressure using the same machinery,, it doors just tap the surface of the eye. Ideal value of 14 :)

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