Freaking out! ~ Is dilation really necessary? Trust issues
Hello, It's been a while since I have made a post on this site. But once again im in a delema.(Uveitis since march 09) I have moved from the state of FL to NY state. I am about 2 hours north of manhatten. I finally found a good eye doctor, (so I think)His name is listed on Fosters site as an Uveitus Specialist.(Dr. Liggett) In Old Greenwich CT. I was tossing up the idea of Manhatten but it is kinda far and I cannot drive in the city for the life of me. I've seen him 2X now, He is a surgen and deals with retina's mainly. Which I think could be a good fit for me. However the last 2X that I have gone his office wants to dilate me. My problem with that is that my left eye The pupil is permentally stuck open due to the mucles stopped working with all the damage that I've had to my eye. I'm scared to death to let anyone give me any more dialtor drops cause im scared that my left eye pupil will be open even more. I understand that he may need to look at the back of my eye but... Since it is open already and he has said that he can see in the back of my eye....but they are unable to do the test where they inject you with the die in your arm. to take some pictures. Now I had that test done in FL with my eye specialist there not long ago. I understand that every doctor needs/wants to do there own but how necessary is it?
Then this morning his office called me to cancel my app (which they seem to do everytime)and told me that my doctor would like me to see his partner, I asked the girl if he specilized in Uveitis. She told me that she has no idea what that is!!! This scares me! This makes me wonder what kind of office im going to when the girls at the front desk are clueless! So I looked up his partner and on the site it says that he is a board certified in ophthalmology and a vitreoretinal surgeon . Is this the right person for me to see? it doesn't say anything about Uveitis. I don't know how to go about finding out more about him. I asked the girls at his office and they once again told me that he is a retina specialist.
I think my issue is that in FL I had a great doctor I completly trusted him 100%. ( I also got his name from fosters site) He was a good man. I would put my faith in this man any day. My issue now is that Im finding it hard to "trust" this new doctor. Im scared, worried and very upset. Which is not good for my eye im sure. Ive gone through everything with this eye and now finally, finally it seems to be better. My fear is that is will reaccure/come back. I'm worried about the dilation drops. I really don't want to do them if i don't have to?
Any ideas? Sorry so long..
Re: Freaking out! ~ Is dilation really necessary? Trust is
HI blubird,
Sorry you're having a tough time. Seems to me that if you have uveitis you should be seeing someone with specialty training in that area. Are these just routine visits or are you having a flareup of your uveitis? Why does Dr. Liggett want you to see his partner?
You can always post a question on "Ask Dr. Foster" if you need further advice. I don't know a lot about dilating drops, so can't really help you there. Hope things settle down. Let us know how you are doing.
Re: Freaking out! ~ Is dilation really necessary? Trust is
is your uveitis in both eyes and do they want to dilate the eye that doesn't have the stuck open pupil? if not and they want to dilate your left eye to do an angiogram. if the muslces are no longer working, nothing will open them any wider. if the inflammation is in only the one eye, could it be caused by the herpes virus? (common result of herpes virus uveitis along with elevated intra ocular pressure and which doesn't respond to steroids)
your best bet would be to travel to NYC, See Dr Samson for treatment and perhaps an OCT scan as it can tell if CME is present etc if you cannot get the Fluorescein angiogram done. Another option is to travel to Boston/Cambridge and have Doctor Foster or Dr Hinkle on your team.
a retina specialist is not necessarily a specialst in uveitis as they are separate fellowships. usually anyone who has done fellowship in uveitis/ocular immunology will list it as a separate specialty. ( Dr Quan Nguyen does this in Baltimore for example).
repeat FA's are done to see if there is active bleeding or CME present or new blood vessel growth of the retina, optic Disc and to pronounce lesions of the retina etc. I assume your records from your doctor in Florida have been sent to your current opthalmologist and he is trying to determine if things have worsened or gotten better. I don't know of any doctor who would order an FA just for the heck of it if he didn't suspect changes most often worsening of the condition.
Re: Freaking out! ~ Is dilation really necessary? Trust is
Thanks for the replies, I have taken your advice and made an app. with Dr. Samson in NYC for Nov. I have heard that he specializes in Uveitis and I will just have to "trust" what he wants to do.
Thanks again
Re: Freaking out! ~ Is dilation really necessary? Trust is
Dr Samson is an Ocular Immunologist trained by Dr Foster at Harvard and MEEI. he IS a uveitis specialist trained to employ the latest meds and to treat underlying systemic causes of uveitis. you will be in good hands.
Re: Freaking out! ~ Is dilation really necessary? Trust is
Keep posting here, hope you get good news and feel you are on the right path, best wishes!
Janine
Re: Freaking out! ~ Is dilation really necessary? Trust is
Hi Bluebird,
Quick comment. Retina specialists are often the ones who see uveitis patients when there are not specialists available. This is because uveitis often affects the retina. All retina practices have the patient's eyes dilated prior to examination. It is a matter of routine. Uveitis patients should clarify with the treating physician the need for a dilated exam. Probably not. You will have to remind the staff that you are there for uveitis and not "retina" and that you don't need a dilated exam (if that is the case).
In fact, it is more difficult to observe cells in the anterior chamber when the eye is dilated, so you should be examined with regard to anterior uveitis ("iritis"), if that is your condition, PRIOR to being dilated.
Dr. Foster used to see patients one day a week in the Retina Service are of the hospital; this was a training function. I had to remind them all of the time not to dilate my eyes.
Cornea specialists, on the other hand, never dilate the eye unless they suspect a problem in the back of the eye.
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