Angiogram for Eye?

[Rena2013]

Hello everyone,

I am a nurse.  My mom recently had gone to her Optomistrist noticing there was a change in her Left eye vision.  She has quite deep Myopia as well.  So what she describe it as:  during focus/concentration at one spot the peripheral side of her left eye field of view is distorted, the lines especially become wavy.  So then she was referred to go to her ophthalomogist.  He told us it could be related to her retina and her deep myopia and said he didn't see fluid in the back of the retina.  He also said he wasn't 100% sure but possible he saw some bleeding in the back of the eye?  But had to do an angiogram to be sure.

So then we scheduled for aniogram that's 4 weeks from now.  Is it too long of a wait?  Should i take her to the ER?  Anyone have any ideas what this may be?

[JohnHaganMD]

I know from many sources and personal discussion as well as articles by reporters about their own eye care that in Canada and UK that this sort of delay is common and apparently acceptable to the people that run the system. In the US it would fail standard of care and get a optometrist or ophthalmologist or insurance company sued.

Do what you can. If there is an opt out that allows you to see a retina MD consider.

When this is resolved and your have a finding please post so that others can follow this to a conclusion.

[Rena2013]

Well I live in Canada, so the only access to ophthamologiest or a retinal MD is through your optomistrist.  However I will seek the optomistrist to see if we can get another MD for second opinion.

[JohnHaganMD]

Sorry long day and I'm a little tired. I should have added some "reasons"   If there is neovascular macular degeneration NVMD  then there could be a larger hemorrhage at any time which dramatically reduces the success of treatment. If there is NVMD then the standard treatment is an intraocular injection of a VEGF inhibitor usually avastin, lucentis or eylea. There are other possible causes such as a small blocked artery or vein or leaking fluid (macular edema).  Such a delay is not standard of care is USA.

[JohnHaganMD]

Yes given that this is either a sudden change that your mother noted and the optom also it deserves a very quick work up. The reason is that it could be either age related or myopic neovascular macular degeneration.

She needs to see an ophthalmologist, if possible one that specializes in retina/macular disease.  The new test that usually gives the answer is very easy to do and is called a macular OCT  if that is indeterminate than a retinal fluoriscene angiogram (of the eye not brain and carotids) is usally done at the same time.   I don't know where you live but retina ophthalmologists would not let your mom walk out the door without one or both tests being done. See if you get her to a retina MD tomorrow.  ERs are not equipped to do this testing.

JCH MD