Eyes

Under the Microscope

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“Have I seen you before?”

“No, I don’t think so. I definitely saw someone else the last time I was here.” But he definitely felt somewhat familiar as I walked into the exam room and took a seat in the chair.

“So, Frank, tell me your story.”

“Well, I have type 1 diabetes,” I blurted out. “So I’m here for my annual eye exam.”

I can’t exactly remember where the conversation went from here, but he definitely stressed the importance of eye checks and diabetes and commended me for coming in.

“Are you well controlled?”

I chuckled. “As best as I can.”

He asked me what my hba1c was, and I told him.

“How many units of insulin are you taking per day?”

“Around 35 units.”

“Lantus? Or Novorapid?”

“I use an insulin pump. So just rapid acting.”

He seemed somewhat surprised to see someone with a pump, even though he clearly knew what they were. As he asked me how long I’d owned it and how I found it, it was clear he seemed to think that they make diabetes far easier to ‘control.’

He placed the dilating drops into my eyes, and handed me a tissue. “If I don’t make you cry, I haven’t done my job correctly!” He joked.

He brought up the eye scans from my pre-appointment screenings, and explained that diabetes is of particular concern to the smaller blood vessels in the body, in places such as the eyes and feet. He showed me a scan of my eyeballs, and identified a tiny haemorrhage from one of the blood vessels on my eye. There was another one on the other eye.

I took a deep breath, but as he went on it didn’t seem to be anything of concern. He showed me another image of a straight line, interrupted by black spots where my retina was.

He had me peer into the microscope, and shined that bright line of light into the back of my eyes, directing me to look left, right, up and down.

“I’m really happy with these eyes. These are a really good set of eyes.”

I sat back in the chair, and we talked a bit more about diabetes. He expressed that there are so many tools out there today that give people with diabetes a really good chance to manage their condition well. He also remarked that GPs don’t know a lot about diabetes.

I concurred, telling him that a lot of people aren’t being linked into the support that they need. I told him that I was living in the dark for the first couple of years, and wasn’t all that engaged in my care until I linked into knowledge and peer support online.

“Oh – and hba1c isn’t the gold standard, either,” I blurted out. “I could have a hba1c of 6 that was full of highs and lows.”

He expressed that there’s a lot of unnecessary doom and gloom in diabetes. I was happy to talk about some of my past involvements with Diabetes Australia, and how much more input I am noticing from people with diabetes. That the messaging is striking more of a balance between the seriousness and not scaring people off of a cliff. But that other orgs are still catching up.

“Is there anything else?”

“What’s your connection to diabetes? You sound like you must have some kind of interest or experience with it.”

“Diabetes runs in my family. So far I seem to be the exception, touch wood.”

He beat me to my next question, asking me if there was someone who he could send a report to. I gave him the name of my endo, and then asked him for his card.

I don’t think I’ve ever had someone explain my eye scans so carefully to me. He didn’t know everything there was to know about diabetes, but then again who does? He approached it with the seriousness it deserved, but he was also a fellow human being with whom I could have a conversation with.

He ‘gets’ it. I knew that I would make sure to request him when I return for my next screening in 12 months time.

“So, is that – haemorrhage something that gets worse?”

“They come and go. Sometimes they’re triggered by things like sneezing or coughing. If I scanned your eyes in a day or two, they’d probably be gone.”

Dilated.

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I took a seat at the back of the store, thankfully behind a wall which provided me with some privacy from customers shopping. I placed the tissue which I had used to dab my watery eyes into my bag. With 20 minutes to kill, I pulled out my phone. I scrolled through my feeds, watching them get blurrier with every passing minute.

The office door in front of me opened, and I was finally motioned into a dark examination room. I took a seat on the wooden beech chair, placed my chin onto the little chin rest, propelled my head forward and peered through. I watched as an image of a country road in the desert was swapped out for darkness, save for a green light.

Relax. Nice and wide. Looking at the green light.

I blinked, uncontrollably, somewhat startled by the small puff of air that entered my right eye.

One more time. Nice and wide.

I struggled to regain control over my blinking, trying to convince myself that nothing was coming into the way of my eye.

After repeating the exercise on my left eye, we got up and shifted into the Optometrist’s office.

How did you get here today?  

I drove here. I’ve just come from work.

Did you bring your sunnies?

Nope, I replied, thinking about how grey and miserable a day it was outside.

How’s your vision? Not too bright?

Fine.

Following my Optometrist’s instructions, I looked to the left, then up at the ceiling, then to my right, and then to the ground as he shone a blazing white light over each of my dilated eyes.

I sat there, feeling like a bundle of nerves, while telling myself that it was unlikely that much would have changed since my last diabetes eye check 12 months ago.

I’ve visited an Ophthalmologist at the hospital before, prior to learning that my Optometrist can do the same eye screening with far more convenience for me and completely covered through Medicare. My endo is happy with this arrangement, and I know that an Ophthalmologist is my port of call if any eye changes are detected during these appointments.

Okay, we’re done. You can sit back.

Your eyes look nice and healthy. There are no signs of any diabetic changes. We’ll see you again in another 12 months.

I shook his hand and thanked him, pleased that I could check another thing off my ‘to do’ list.

Getting My Twitch Checked

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For the last couple of weeks, I’ve had a bit of a twitch in the bottom corner of my right eye. Like a rapid, vibrating sensation that comes and goes. And every time that it happens, I have the sudden urge to rub my eyes to try and make it stop. And every time that it happens, it annoys the hell out of me.

I didn’t want to take it too seriously because I’ve been on holidays over the last two weeks. But everytime a bad reading came up, I would feel guilty. And everytime I ate more than I should have, those horrible thoughts of complications would plague me. Crazy theories would run through my head at night. What if the blood and oxygen was struggling to get through? What if, somehow, I’d damaged one of the blood vessels in my eyes?

Yesterday I said I want to make more of an effort with my diabetes. That I want to take things more seriously than I’m currently doing. And after writing that post, I made an appointment to see the optometrist during my lunch break today. It’s been well over a year since I last got my eyes checked, and this twitch seemed like the perfect opportunity to shoot two birds with one stone.

I felt so serious, and so unenthusiastic as I was called in and sat down in that chair. I almost felt like I was in a job interview, justifying my reasons for being there.

“I’m here for two reasons today. The first one is that I have type 1 diabetes, and I want to have the back of my eyes checked. The second one is that I have a bit of a twitch in the corner of this eye, and I wanted you to have a look at it.”

He dismissed the twitch straight away, telling me that heaps of people get it. It’s triggered by stress, and that getting a good night’s sleep and cutting back on stimulants will help. And considering that I’ve practically been living on coffee during my holiday, this made complete sense. I’ve still been craving those coffees I’ve been having on my holidays since I came home. My morning espresso at the corner downstairs. The cappuccino with my big breakfast. And my afternoon coffee and cake at my favourite pasticceria in Sydney, Via Del Corso.

https://instagram.com/p/5BtCfHA_e0/

 

I think I’m getting a bit carried away…

The digital retinal scan of my eyes looked fine. He also told me that my eyesight hadn’t deteriorated over the last 12 months, which would have been a sign of badly managed blood sugar levels.

To be honest, I was a bit bothered that he didn’t seem to take my concerns as seriously as I did. He gave me the impression that I didn’t need to be there, considering that I’d had an eye check last year.

“I’d rather be safe than sorry. I’d rather be safe than sorry, because I hear all these horror stories about diabetes and complications…”

I didn’t feel like I’d finished my sentence, but I trailed off and couldn’t get anymore words out. Maybe he didn’t fully understand the seriousness of diabetes. Maybe he didn’t get what complications were. Maybe in his eyes, it was all for nothing.

But in my eyes, I’d dismissed a major concern on my mind. In my eyes, I’d taken things more seriously than I normally would have. And in my eyes, it was better to be sure. I was able to walk out of there today feeling a little less heavy, and that was well worth the effort.

And those good results are definitely a start towards doing more for my diabetes.