Any Opticians/Ophthalmologists about?

[Wysterias]

Hello,

Before I take things further, please could anyone advise if an Ophthalmoscope with the bright light be used on a patient that has had their pupils fully dilated please? Thank you

Anyone? I had a rather traumatic experience at Eye clinic recently and I just wondered whether it could have been avoided if things had been done differently. Thank you

I have had hundreds of eye exams and yes the light has always been used when my pupils were dilated. I've also had a lots of photos taken of the back of my eye with pupils dilated and bright flashes.

Similar to above. Yes, it's normal to have your pupils dilated and the bright ophthalmoscope used, so they can actually see the back of your eye. Did something happen? It's a little uncomfortable at the time, as naturally your pupil would contract to light, but it can't. But it's over quick and it's how they examine the retina fully.

Yes it's supposed to be used when the pupils are fully dilated.

I had to learn on undilated pupils and you could never see anything.

DH unfortunately spends a lot of his life going to eye clinic and a lot of the tests are horrid - I don't know how he puts up with the eye pressure one where they do a puff of air at your eye.

@Wysterias yes, it is - it won’t damage your eye, but as with any medical procedure, if you’re finding it uncomfortable, let the practitioner know. (I’m an optometrist)

@AnnaMagnani like your DH I spend an inordinate amount of time at eye clinic, the puff of air is fine you get used to it. The one I hate is the photography with the really bright flash and the fact that they have to use a dye called flourasine to get good images of the blood flow and I have a bad reaction to it every time, so the routine is: dilate pupils, wait 20 mins, have dye injected, spend 10 mins throwing up, take bright flashy photos, make my way home with sunglasses on and a bit blurry, then spend 24 hrs with bright yellow nail beds, eyeballs, fluorescent pee and a slight yellowish tinge to my skin. It ain't glamorous and that's for sure!

Yes, they usually have to dilate your pupils and use a very bright light to see inside your eye clearly. It can be uncomfortable but it is normal I'm afraid.
What happened today and what do you wish they had done differently?

could anyone advise if an Ophthalmoscope with the bright light be used on a patient that has had their pupils fully dilated please?

Yes. They have to drop a mydriatic (pupil-dilating drug) into your eye before doing a retinal examination, otherwise the pupil will constrict in response to the light and there will be parts of the retina that can't be seen.

stanfordmedicine25.stanford.edu/the25/fundoscopic.html

@FatAgainItsLettuceTime that sounds awful ! Especially when you know it;s going to happen! Is there nothing you could be given to help ?Anti histamines ? Anti emetic ?

I'm very sorry to hijack but I just want to quickly ask if the narrow drainage channels which recently meant a no to pupil dilation could have developed recently .I'm surprised they've not been noticed in any previous tests .

I've had dozens of diabetes eye exams. Bright light/slit lamp is standard

Why what happened? Hope you are ok

*dilated! Not diabetes

Yes, I have it done regularly at the eye clinic. Every six months. Inalways have drops to numb my eyes first though. The numbing drops do sting though.

Thank you all for your replies.

I wasn't sure what seemed to go wrong /felt different this time.

I have never had a problem with my eyes up until 4 weeks ago when it transpired I had burst a blood vessel on my retina.

I was sent to Opthamology.. Had the stingy eye drops (the nice eye drops first, then the stingy ones). Fine. Had eye scan. Fine. Then the Opthamologist saw me and had a look in my eye. Fine. Sent me away to come back again in three weeks.

Yesterday had my follow-up. Was supposed to have the scan again.

Had eye drops but nurse said sorry, I have done them the wrong way round. Didn't think any more of it.

Went into waiting room.. No scan.. Called into see doc who was a bit miffed I hadn't had a scan as he wanted to know if the bleed had gone.. So he used his Opthamoscope to try and see but compared to last time, it was beyond uncomfortable, it was horrific and I was almost in tears. He was getting cross that I couldn't 'just look at his ear' and I kept instinctively backing off because of how torturous the light was. I ended up just looking as far to the left as I could so he ended up not being able to see. I literally could not cope with the light as I managed to last time although I don't think he spent as long looking last time as he did this time.

I then sat back whilst he told me couldn't tell if it had gone and would need to see me again. I then started to feel really faint (not that he noticed until I told him I really didn't feel well despite having my head in my lap whilst he was talking to me). I started feeling really sick and told him, to which he said 'don't do that, I'll call someone'.. I went to stand.. Wobbled.. He hit the buzzer and I collapsed in a heap!

Apparently my blood pressure and blood sugar tanked but I came to aftercare while (and very lovely nurses). I apologised, left the room and found my husband. Suddenly had an almighty frontal headache come on from nowhere and fainted in the car again!

The headache was awesome. I get occasional migraines which can be triggered by camera flashes so I wondered whether I just badly reacted this time to the light and it triggered something?

His manner was shite tbh. The nurses were great but he wasnt pleasant. I have probably had 10 fainting episodes in my 45 years but I'm no wimp. I've had eye tests before but this was different. It was bloody torture and I've got to back in three weeks. Did they do something different? Or am I freak with a weird brain? TIA

ETA..

Sorry if its a stupid question but I assume there's not a light on the Ophthalmoscope that is too bright for dilated pupils? Once he knew I hadn't had the scan, could he have thought I hadn't had the drops that? Just a thought, probably a stupid one.

Yeah, it’s kind of staple. I speak from the experience of literally hundreds of eye hospital visits.

*hadn't had the drops either

I'm sorry to hear you had such a horrible experience OP. He will have been able to see that your pupils were dilated so he will have known you'd had the drops in. Why didn't they do the scan? No wonder he was miffed, that was the whole point of you being there.
Regardless, for whatever reason, the light and maybe the stress triggered a reaction in you and the doctor didn't sound very sympathetic. Sometimes doctors are so busy thinking at 100mph about what the diagnosis could be, the alternative diagnoses, what they need to do next, what problems could occur if they do/don't do xy or z that they sometimes forget to be as kind as they could be. I'm glad the nurses were lovely.
I wonder if it's worth seeing your GP about what happend?

having recently been told that i have v narrowed drainage channels in my eyes i'm probably seeing connections where there are none and of course i'm no expert but ...
dilating pupils where someone has narrowed channels can increase the pressure in the eye

Acute angle-closure glaucoma is a serious eye condition that occurs when the fluid pressure inside your eye rises quickly. The usual symptoms are sudden, severe eye pain, a red eye and reduced or blurred vision. You may feel sick or be sick (vomit). Immediate treatment is needed to relieve symptoms and to prevent permanent loss of vision (severe sight impairment).

apart from my musing above ,it sounds awful and the treatment unprofessional.i understand the comments from NHS but don't think they excuse a HP ignoring the patients extreme pain and carrying on .

@amberedover are you asking if using the dilating drops can cause narrow angles? If so, no.
But, it you have very narrow angles it's not safe to dilate in case if causes a blockage.

Angles become more narrow with age as the lens thickens, certain eye conditions can also cause them to become narrower.

I was diagnosed with a macular hole, and acute angle closure glaucoma both at the same time 2 years ago. I had headaches, nausea, and couldn't walk in a straight line. I was staggering about as if I was drunk because I couldn't see properly and was feeling disorientated and sea sick all the time.

I had to have a peripheral laser iridotomy to sort out the glaucoma, and vitrectomy for the macular hole. I've been left with distorted vision in one eye and little black floaters.

Both operations can cause cataracts, and I've had surgery again for that in the one eye that had the macular hole. The sight in that eye is now pretty poor. A cataract is forming slowly in the other eye too. I've been advised that one eye is now no longer has good enough vision for driving.

I have to have annual check ups at the opticians. I've had so many hospital visits in the last two years with scans and stingy eyedrops and all kinds of stuff. It's no fun and I feel quite down about the sudden deterioration of my eyesight at a comparatively early age. I'm 57, and everyone else in the eye clinics have been at leat 20-30 years older than me.

Yes. It’s sometimes uncomfortable looking at the unbearable bright light but has to be done. I have this every 6 months, and depending on how flared up my eye conditions are it can be bearable or toe curling, teeth clenching awful. But far better than having to put up with eye pain.

@underneaththeash no it's ok ,I wasn't thinking that dilating pupils could cause
narrow angles .

I was wondering ,in a previous post ,why mine weren't spotted in eye tests carried out a few months earlier .Perhaps because the eye tests were for glasses only ?

@RainyReadingDay oh dear ,that sounds awful .No wonder you're feeling down .
I'm being assessed for peripheral laser iridotomy and I already have cataracts .And horrible floaters .Feeling nervous now .