Dr. David Mitchell, Optometrist, Vancouver, BC

Recent Health Talks Authored by Dr. David Mitchell

• 

  3

  Diagnosing Diabetic Retinopathy

  Jim is a 31 year old male whose last exam was 8 months ago. He feels his vision has worsened. He reports good health and currently takes not medication.

  Current glasses provide 20/40 acuity and this can be improved to 20/20 with an increase in the myopic correction. On retinal examination, numerous haemorrhages were found int the mid periphery and the periphery of both eyes.

  He was referred to a retinal specialist to confirm the diagnosis of diabetic retinopathy. He should be seen by his family doctor and possibly an Endocrinologist. He might also benefit from seeing a Diabetic Nurse Educator and a Dietitian, as sudden changes in his vision can be a result of fluctuations in blood glucose levels. He should also visit his local pharmacist to discuss blood glucose monitors for self monitoring at home.

  Diabetes is the leading cause of blindness int he western world. It can affect all organs in the body but is commonly detected first in the eyes.

• 

  7

  Retinal detachment detected in a routine eye exam.

  David is a 45 year old male who came in for routine eye exam. He had no visual complaints and had laser refractive surgery 4 years previous. Uncorrected vision remains 20/20 and no correction was suggested.

  Dilated retinal exam including digital scanning ophthalmonoscopy found a retinal detachment in the mid periphery of the right eye. He was immediately referred to a retinal specialist who completed successful surgery that afternoon.

  Not all retinal detachments come with the classic signs of floaters, flashed and veiling of vision. The retina has no pain fibres, so many detachments are asymptomatic.

  David will have to continue seeing an optometrist and possibly an Ophthalmologist for routine exams to screen for other eye conditions such as glaucoma, macular degeneration, cataracts and diabetic retinopathy as he ages.

• 

  9

  Retinal Detachment Detection and Treatment " David is a 45-year-old bank manager "

  David is a 45-year-old bank manager who visits his optometrist for a routine eye exam. He used to wear eyeglasses, but had laser eye surgery 4 years ago to correct his vision.

  Upon examination, the optometrist discovers that David's uncorrected vision is still 20/20 and he requires no correction. A dilated retinal exam was conducted including digital scanning ophthalmoscopy to take pictures of the eye and determine the health of the retina. A retinal detachment was discovered in the mid-periphery of the right eye. Not all retinal detachments come with classic signs of floaters or other vision changes, so it is not uncommon to see a retinal detachment with absolutely no symptoms. David is immediately referred to a retinal specialist who completes successful surgery that afternoon and corrects the retinal detachment.

  It is important for David to carefully follow the recovery plan following his surgery with respect to pain management and caring for his eye. Retinal detachment may not always be prevented, however is sometimes linked with inflammatory conditions, high blood pressure and cataract removal. David should follow up with his family physician to see if he has any uncontrolled health issues that should be managed, and could see an exercise specialist and/or massage therapist to increase his activity level and help with relaxation techniques.