How To Use An Ophthalmoscope To Check For Diabetic Retinopathy - Dr Gill

Diabetic Retinopathy - Using an Ophthalmoscope - Clinical Skills - Dr Gill
Diabetes whilst a huge problem for general health, both in the UK and frankly internationally, is ALSO one of the leading causes of blindness as a result of diabetic retinopathy
Using an ophthalmoscope is useful in diabetes as it allows us access to the only part of the body where the microvasculature can be reviewed non-invasively, by looking at the retina
The core concept of screening for diabetic retinopathy is not merely to pick up and the various stages of retinopathy, but to also work as a weather bell with regard to the patient's overall diabetes
In this video, we review the structures of the retina, as well as discuss the four stages of diabetic retinopathy through to the end stage proliferative retinopathy, as well as discussing associated conditions such as glaucoma, cataracts and diabetic maculopathy where people will lose their central vision
#Diabetes #Retinopathy #DrGill #ClinicalSkills
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Introduction
01:00 - Importance of Ophthalmology in Diabetes
02:17 - Understanding the Retina
03:30 - Fovea: The Most Sensitive Part of the Eye
04:48 - Anatomy of the Retina: Rods, Cones, and Blood Vessels
06:21 - The Impact of Diabetes on the Retina
06:55 - How Diabetes Affects Blood Vessels and Causes Organ Damage
10:01 - Stages of Diabetic Retinopathy
11:31 - Background Retinopathy
12:46 - Moderate Diabetic Retinopathy
14:52 - Severe Diabetic Retinopathy
16:18 - Proliferative Diabetic Retinopathy
18:15 - Importance of Retinal Screening
19:15 - Diabetic Macular Oedema
21:18 - The Importance of Managing Diabetes to Prevent Eye Damage
23:53 - Final Thoughts

[@guilhermenunes4275]

the transition between cameras is exceptional ! your editor is doing a good job

[@DrJamesGill]

thanks, I'm the editor. I have to do the whole thing :)

[@bigbadbomba]

My sister reached severe stage retinopathy when she was 19 and almost went completely blind. Thankfully doctors were able to laser the vessels closed, and she became much more compliant with diabetic self care. Had good enough vision to drive for 10 years now!

[@DrJamesGill]

I'm pleased to hear things stabilised, but sorry that it took that in order for her to get the control

[@thomashow3348]

I started watching your videos for asmr months ago, but this video is so helpful! My girlfriend has diabetes but has only had some small tests conducted due to covid. Shes very recently started getting blurred vision so we booked in for an eye test. Thank you for showing me how important it is that we buckle down on diet and ensure we get the right tests and treatment regardless of covid. Keep it up boss 👍

[@TedAtreides]

outstanding information that can be understood easily with the given visuals. Thank you Dr. Gill

[@DrJamesGill]

Thank you. Any other suggestions on how we can improve the deep dives?

[@DevRSVR]

This was great Dr Gill thanks. My family have been affected by diabetes in different ways due to alcohol consumption. They have lost limbs etc. It would be great if you could do a piece on Hemochromatosis. It also effects members of my family and its not well known about. Keep up the good work!

[@DrJamesGill]

I’ve had a few patients with haemochromatosis. It’s likely that it will come up in other videos. But never know, there may come a reason to do a full video on that 😊

[@CottonCandyGabe]

As a type 1 diabetic, one of my biggest fears has been going blind. Sadly I had mild diabetic retinopathy last time I went to the doctors, and I’ve never gotten better. My eyes are just in absolute agonizing pain. Feels like someone’s literally squeezing my eyeballs without stop. Almost feels like I want to rip my eyes out at points. Take care of yourself people. Laziness is the worst drug out there

[@DrJamesGill]

Unfortunately the eye changes don't resolve, but we can stop them getting worse in many people, but with type 1 DM it is a bigger challenge. I hope your medical team are able to help

[@kapitanleutnant1]

I happen to have type 1 diabetes since 1995 and I’m never giving up hope for the cure

[@DrJamesGill]

we do have some good treatments, but as you saw, cure is not really present yet. I've had one patient with a pancreas transplant that did quite well

[@angelinamincer3040]

This dudes a legend

[@ebonybunor6796]

your videos are very helpful and you're very eloquent.thanks

[@marinitsag]

Thank you for your educational videos Dr. Gill, you always give us clear and precise information to understand each subject

[@DrJamesGill]

Glad you enjoyed it. Thanks

[@cuteface88]

I love listening to you explain things. I have no reason to know any of this medical stuff. I just watch your videos for fun because they chill me out.

[@DrJamesGill]

Thank you 😊 It’s always good to know how our body works

[@pinkhoneyxx]

Very educational video! Thank you so much Dr. Gill!

[@DrJamesGill]

👍

[@tanksoldier]

Medical info outstanding, vest game on point…

[@kanizfizzaaftab4486]

Excellent presentation! Thank you for this

[@DrJamesGill]

You're very welcome!

[@ferrino73]

Brilliant. See so much of this in theatres and with covid slowing us seeing patients the cataract are getting so much denser. But after cryo, laser and detachments being treated the results are amazing. Great job explaining this and look forward to more dr.gill

[@DrJamesGill]

my gran is waiting for her cataract operation, and the sight has unfortunately been impaired by her diabetes

[@ferrino73]

@@DrJamesGill I'm sure the surgeon will do his very best, fingers crossed

[@kittybala7951]

Looking forward

[@jonathandball]

Immensely helpful! Thank you.

[@DrJamesGill]

Glad it was helpful!

[@JadeRyuu]

I'm a Type 1 Diabetic and was misdiagnosed for 10 years and not given insulin and brushed off as I've always been heavy set. (Which I'm working on & I'm a much better controlled diabetic since having insulin for 8 years now!) With being misdiagnosed, I ran the risk of so much damage. Which my doctors were so amazed my heart & kidneys are in such good condition. We found too late that my eyes and nerves (more generalized diabetic neuropathy in the hands/arms & legs/feet) have faired much worse. My eyes have taken so much damage. I've had bleeding and blood collection that required laser treatments for both eyes (3 in the right and 5 in the left), and finally injections and surgery of the left eye to clear it up. Now at 33, I've been forewarned that cataract surgery will be required in an estimated 2-3 years. Not to mention other health issues. That all said, this video was informative and interesting, and helped me to understand more about my eye health and how eyes actually work! Thank you for being so clear in your descriptions of how it all works, and sharing knowledge! Please take care!

[@DrJamesGill]

I’m so sorry you had these issue. The problem is that type 1 diabetes tends to be either from birth or as a result of an injury to pancreas, whether that is a direct injury, or something like an infection Hopefully with tight control you’ve be able to slow down further changes Another video that might help you - this is the yearly diabetic review we do in the UK kzbin.info/www/bejne/hJTYaphtq9WajJI

[@Derokas]

Thank you very much!!!!

[@Joey98]

Smashing video, Doctor. Really appreciate the information. All the best.

[@DrJamesGill]

Thank you. We’ll follow up with hypertensive retinopathy later 😊

[@TheKrinnin]

The timing for me is impeccable to learn more. My Type 1 husband just started eye injections with eventual laser surgery for his retinopathy.

[@DrJamesGill]

oh gosh,I'm sorry to hear that, I hope they go well!

[@XX-gy7ue]

BRILLIANT

[@DrJamesGill]

thanks :)

[@palomathereptilian]

My grandfather had diabetic retinopathy, he had type 2 diabetes and unfortunately he simply pretended he wasn't diabetic for 2 decades until he was diagnosed with terminal prostate cancer - he also got diagnosed with diabetic retinopathy with quite significant damage to his sight some time after... Even with him treating his diabetes during his last 6 years of life, we became legally blind a year before his death in 2015 😔

[@DrJamesGill]

I’m so sorry to hear this. This sort of thing makes me really sad, as it’s possible that there may have been a better outcome with tighter control earlier in his diabetes journey Thank you for sharing. It might help others

[@chubberinaWhispers]

Awesome video. May be your best yet

[@DrJamesGill]

Wow, thanks!

[@starfishgurl1984]

It’s amazing what happens when you get your eyes examined! My former (since retired) ophthalmologist picked up on my fall allergies to certain trees that I wasn’t yet aware of at the time during an eye exam once because of their effect on my eyes. I need a new glasses prescription badly and I’m all out of contacts so I need to schedule an exam, lol, I got a bit behind thanks to covid…

[@melissaaylward9918]

It would be very interesting to see a video on your opinion on various congenital defects. My daughter has multiple including complete agenesis of the right lung and all connecting pathways like the bronchus and pulmonary artery.

[@chuckoneill2023]

Thank you, Dr. Gill. Amusingly, the advert KZbin linked to this video was some Quack diabetes "treatment".

[@DrJamesGill]

I've seen other adverts pop up on YT generally, and I'm amazed some of the snack oil that is allowed to be advertised. It would be against the law on TV in the UK

[@outsidebk1848]

Window to the soul…or diabetes. You’re the best Dr. Gill!!! Great video thank you

[@DrJamesGill]

it's like the hands - a huge part of clinical examination is looking at the hands

[@MrZomg17]

@DrJamesGill speaking of Eyes would you be able to put together a video about Eye Floaters, how to identify them ,their causes and Prevention etc?

[@apotikrumkit2289]

Greetings, doctor Gill. I'm your big fan from Indonesia.

[@DrJamesGill]

Thanks for joining us 😊

[@krisconway2884]

wow wow and WOW that was amazing and really informative and interesting.

[@DrJamesGill]

Glad you enjoyed it!

[@krisconway2884]

@@DrJamesGill my partner has diabetes and this video taught me some things i didnt know bout it.

[@MrBuddybones]

Thank you so much! I am very appreciative. I worry about this. I am diabetic type 2 and my numbers have not been under control in the last few months. I have worried and wondered if I would notice if and when my vision would be damaged by my diabetes. I have lost 40 lbs and was hoping that would get my situation under control. It has helped my blood pressure, which is now fairly normal, but I have not done enough to improve my blood glucose. Metformin is not working alone. My long time doctor retired a few months ago. Burn out. So I have not been properly checked in a minute. Thank you for this detailed information regarding diabetic retinopathy.

[@DrJamesGill]

metformin is good. but it is only one step in diabetes treatment. I filmed a session with one of the diabetic professors last year you might find useful 😊 kzbin.info/www/bejne/q2S0l3mfia-Ufrs

[@MrBuddybones]

@@DrJamesGill thank you for suggesting. I will watch. I am so glad one of your videos popped into my feed last month. I have stuck my head in the sand since I was told I was pre-diabetic 6 years ago. I wish I had listened. It runs in my family, and I had ballooned from 5’9” 130 lbs to 200 lbs in 3 yrs after I quit smoking (still glad I quit for good in 2002). Funny how quitting smoking was the start of my health issues (due to weight gain). So I have lost weight with a health coach provided by my employer. I wonder if I continue to lose weight and eat better if the diabetes will become more manageable? Hoping so. Again, Thank you for your extremely helpful, eye-opening videos. You’re the first doctor to explain things in a way that has reached this ostrich. Lol. - Elizabeth 🙂

[@DrJamesGill]

I’d never be able to say “Do X and this WILL happen” But diet - as in the TYPE, not necessarily the quantity of food you eat is HUGELY important with diabetes. So looking at that area is a huge thing you can do 😊!

[@user-ng2pn8jx2p]

Thank you doctor for the nice information ' congratulation on the beautiful dress

[@DrJamesGill]

Thanks and welcome

[@JasonTheOneAndOnly]

huh, always wondered why it was slightly easier to see things just out of center view.

[@DrJamesGill]

it's one of those little eye facts I love 😊

[@kittybala7951]

Useful

[@DrJamesGill]

Thanks

[@johnathanleonardo912]

Really interesting. My dads got something which are white spots on the eye and if they leak they can cause blindness. I forgot what they're called so he has to take eye medicine and frequent trips to the eye doctor to check the condition of those spots

[@gregorywiederecht]

Weird question Dr. Gill, and I'm sure you've mentioned it before, but what is your specialty as a doctor? I keep thinking of you as a teacher, forgetting you're also a practicing doctor!😅

[@geddoe316]

I have an ignorant response. I believe he is in family medicine, which I guess is like general medicine? So it's like a jack of all trades thing? Perhaps that is why he can cover so many topics?

[@DrJamesGill]

I'm a GP, and yes, jack of all trades is fair. At the medical school I focus on "clinical skills" so literally how to examine people, so that strengthens by knowledge base 😊

[@cindypraytor1491]

Thank you for this information on diabetic. I’m a type 2 and take shots once a week and I worry about my eyes getting bad.

[@DrJamesGill]

control is always going to be the key aspect. Using the three approaches of diet, exercise and medication. But I don't mean exercise in just the sense of "get fit" - 1 hrs cardio has the biological equivalent of ~ 2 units of insulin, so it all aligns together

[@carmenhomer1965]

I make sure to get my eyes checked yearly

[@DrJamesGill]

Super, that’s goood to hear. Eyes are so important

[@carmenhomer1965]

@@DrJamesGill I am a type 2 diabetic and I wear glasses so I try to take care of myself

[@geddoe316]

Interesting how you can detect diabetes early on. I have blepharitis so I am at the doctor often, and I go to a teaching hospital. Many times, I get different residents and almost every time while they examine me, they ask if i am diabetic. Now, the chief doctor just the other day said my eyes looked fine, so I don't know if those residents just ask out of habit or they are seeing signs of something (maybe pre-diabetes?). Nonetheless, maybe that's a subtle hint to finally knock off the soda among other things! :)

[@DrJamesGill]

it's more that blepharitis can be seen in diabetes, but doesn't have to be caused by diabetes. there are many times, I'm sure it annoys patients, when we keep repeating these questions, but they are practically automatic - see symptom X, ask about Y

[@Rambit]

Isn't bleeding in that area typically visualised after having dilated the pupils from administering drops?

[@mikel7509]

25 centimeters, that's a lot to fit inside an eye. Shouldn't that be millimeters instead? Recently got diagnosed with type 2 and am waiting for one of these eye-checkups. unfortunately there's a 3 month waiting queue...😕 Thanks for an interesting video.

[@Roze_aye]

i paused this video and spent a good 10-20 minutes trying to figure out what that dark spot is (i now know its the macula) only to come back and continue. only for james to immediately tell me what the macula is. i played myself

[@DrJamesGill]

🤣🤣 however independent learning is the best form, so I guarantee you’ll remember that better than you would have if just merely told to you 😊

[@blackoutasmr6746]

Dr. I had gastric bypass 1 year ago, my blood sugar drops after I work out. Should I eat something before or afterwards to prevent this?

[@DrJamesGill]

I’d imagine that is because of the work out. Literally consuming blood sugar

[@CJGAJL]

I’ve never been diagnosed with color blindness and go to the eye doctor at least once a year but I can’t see the number in the circle next to the number 12 @5:45 am I partially colorblind I can see the other numbers fine

[@DrJamesGill]

might be worth while looking at some of the Ichihara charts online to check. But it isn't something to worry about as a rule of thumb, it's how we are built genetically

[@kiarona.]

6:00 CAT

[@DrJamesGill]

🐈

[@DrJamesGill]

He’d been dozing on the sofa unnoticed

[@robthompson2269]

My fovea picked up a cat at 6:01

[@DrJamesGill]

🤣 almost photo bombed!

[@solidfeline9093]

Background cat spotted

[@DrJamesGill]

he'd been snoozing on the radiator

[@maclemaster5966]

I didn’t click for same

[@89horizon]

Diabetes, or diabeetus as it's pronounced in America...

[@A.M_vibes]

anyone else think he had elf ears from the thumbnail ?

[@velu2957]

✍️never✍️get✍️diabetes✍️