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[IPk] Eye clinic problems - LONG

Hi everyone

 I've been meaning to write to the list about problems I've been having at the
eye clinic, but kept putting it off. Most of the time, I feel fed up with
fighting for decent care; other times I feel so angry I know I would just rant
and rave. Well, today I decided to try to do something about it.

 Below is a letter from me to my GP, which sets it all out. If you can be
bothered to read it (it is rather long) then I would appreciate anyone's
comments or encouragement to keep going!


IDDM 34 years, D-Tron 9 months

PS I have removed names to protect the incompetent...

Dear Dr Woolterton

 You may recall from my last visit to your surgery that I am quite concerned
about the level of care I am receiving from Mr B's ophthalmology team at C

 This letter is intended to put my concerns in writing and hopefully make a
start toward a satisfactory resolution.

 I saw Mr A, Associate Specialist, on 14 April 2003. This was a follow-up
consultation, following laser treatment to my right eye in February. On this
occasion I was most concerned about Mr A's lack of knowledge about my case even
though he had my notes in front of him - he stated his intention to refer me for
a possible left vitrectomy, but when I reminded him about his previous concerns
about bilateral cataracts, he re-examined me and suggested that the left
cataract should be dealt with first, then the vitrectomy might not be necessary.
I asked him how long I might have to wait for the cataract operation, and he
told me it would be done urgently. He then considered the additional risks that
diabetes would pose, and further decided to refer me to the consultant, Mr B, in
three months' time. This time lapse also concerned me, as his previous statement
seemed to suggest that any action should be taken urgently.

 After telephoning the Retinal Screening Facilitator, speaking with you, and a
letter from my optician expressing her concern, this three month gap was reduced
to two months.

 When I attended this next clinic appointment, I was initially seen by a junior
colleague of Mr B. I protested that this wasn't a routine clinic appointment but
one specifically to see the Consultant, and was told that he would be consulted
if necessary. Eventually Mr B was asked to come and see me.

 Mr B's manner was friendly, but from the start he showed he had misunderstood
the situation. He said he understood I wanted a cataract operation. I told him
that his colleague suggested I should have it, and it wasn't at my initiation.
He examined my eyes and said he couldn't see a reason for either cataract
operation or vitrectomy. I politely asked how two surgeons could have such
different views, and he suggested that things can change on a daily basis. He
asked me if the cataracts were causing any problems. I told him that it was
difficult to tell, as they had been growing very slowly for several years, and I
had therefore got used to them. However, I did point out that I had recently had
a problem, sometimes, following the picture on the television. He made no
comment about this, but asked me if I had re-applied for my driving licence yet,
and encouraged me to do so. I am most concerned that he would let me drive
without further investigating my problems with keeping up with the television

 Mr B also stated that he could see both retinas clearly, and there was no
evidence of anything untoward happening since the bleed in the right eye, which
prompted the laser treatment earlier in the year. I cannot understand this, as I
have had problems with black shadows in my left eye, the type one sees when one
has had a bleed. These shadows have been there for a few months, but not
predating my February consultation.

 I went on to ask him if I could further improve my glycaemic control, since my
eye problems had obviously settled down. Last time I saw Mr B, he insisted that
I shouldn't tighten up my control any more until further instruction from him,
in order to protect my eyes. He even wrote to the diabetic clinic expressing his
concerns. However, on this occasion, he didn't seem to know what I was talking
about, and suggested that question would be better addressed to the diabetic
clinic. I explained why I was asking him. He checked my notes again, and said he
could see no problem with me starting on an insulin pump. I pointed out that I
had been on such a pump for nine months, and now wanted to tighten my control
further. He said he now understood, and suggested I should address that question
to the diabetic clinic. At this point I was feeling quite frustrated, but I
politely explained the whole situation to him again, and he then finally agreed
that it would be safe for me to tighten up my control.

 He then passed comment on the fact that I was "clued up on what's going on".
Surely this is every diabetic's responsibility, especially against Consultants
who don't seem to have a grasp of the full picture?

 As you can probably imagine, I am most concerned that my eye care is in the
hands of this team. I understand that people can have off days, or he might have
had a lot on his mind. However, I expect any doctor to be able to focus on my
case when I am consulting with him. I have no respect or trust in the two senior
surgeons in this clinic any more - this is not a good basis for "partnership in

 Considering that my case is complex (this is why Mr A didn't want to make the
final decision) and my concerns for the competence of Mr B and his team, I would
be grateful if you would consider referring me to Moorfields Eye Hospital, who
have a great reputation and very specialised care. I must stress I am not
seeking any operations, merely good care from a competent team whom I can trust.

I look forward to hearing from you soon.

Yours sincerely
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