Digital Medical Retina – Diagnostic Clinic (DMRD Clinic)

Digital Medical Retina – Diagnostic Clinic (DMRD Clinic)

What is the Medical Retina Diagnostic Clinic?
This is a special clinic to assess the eyes of people who have (either) been referred by the Diabetic Eyes Screening Programme (DESP), other health care provider or who are already under follow-up in the eye clinic with stable diabetic retinopathy, retinal vein occlusions, or other suitable retinal diseases.

Diabetes and retinal vascular diseases can affect the tiny blood vessels in the retina (the layer at the back of the eye that is sensitive to light). In some patients, treatment can prevent irreversible sight loss. It is therefore very important that we pick up any problems early. In this clinic, we will assess your eyes with specialist imaging (see below). Depending on the results, we will then plan treatment or further follow-up. We will send you a copy of the relevant patient information leaflet if treatment is necessary.

How does this clinic work?
The clinic is run by trained ophthalmic nursing staff at the Princess of Wales Community Hospital (POWCH) in Bromsgrove. You will be asked a few questions about your health and eye sight, which we would be grateful if you would answer to the best of your knowledge (a questionnaire may be posted to you with this information leaflet so that you can write down your answers before you come to the clinic).

You will then have several eye tests, including:

• Visual acuity test: a sight test that measures how well you see in the distance.  Please bring your most up-to-date glasses to the clinic.  (Bring the glasses that you have been prescribed for television or driving – unless none have been prescribed for you.) 
• Digital photographs: similar photographs may have been taken at your local DESP appointment or by your optician but we have an OPTOS camera which takes wide angle pictures of the retina.
• Digital imaging: an Optical Coherence Tomography (OCT) scan uses light reflected from the back of your eye.  This gives useful information about whether you have any fluid at the macula (the centre of the retina at the back of your eye).
• Eye pressure check
  
  

You will not see a doctor during your appointment, but after the clinic, your results will be checked by a consultant, a senior doctor or an advanced ophthalmic nurse practitioner. We will write to you to tell you the results and the plan for treatment or follow-up. We will send a copy of the letter to your GP and also, if appropriate, to the DESP or to your optometrist.

Your clinic visit will have one of the following three outcomes:

1. You may continue to be monitored in this clinic at appropriate intervals.  Sometimes, if needed, you might be sent an appointment for a face-to-face assessment. 
2. You may need treatment with laser or eye injections.  In this case, you will need to come to the appropriate eye department, so that, with your informed consent, we can treat your eye.  Information about the treatment concerned will be posted to you and you should read this before you come. When you come, you will have a chance to discuss any questions with the doctor or nurse practitioner. If you agree to have the treatment, you will need to sign a consent form (unless you have previously signed one for this treatment). 
3. If your eye condition does not require care in a hospital eye clinic you will be discharged for regular checks under the care of your optometrist or the DESP. If the situation changes in the future, they will refer you back to the hospital.

How long is this clinic appointment?
We aim to finish all your tests within an hour. However, in some cases it may take longer.

Can I drive to this appointment?
In most cases, patients who drive a car can drive to and from the clinic because we can get good images without using eye drops to make the pupils big. On rare occasions we may ask a patient to return on a later date for eye drops before the tests are done. If you need to return for these drops please make sure that you do not have to drive during the four hour period after the drops. 

I have diabetes.  Do I still need to attend the community Diabetic Eye Screening Programme (DESP)?
While you are under the care of the DMRD clinic you do not need to attend the DESP.  If you have stable diabetic retinopathy you may be discharged from the hospital clinic.  If you are discharged, it is important to attend appointments at your local DESP.

What can I do to reduce the risk of my eye disease getting worse?
If you are a smoker please try to quit, as smoking may affect the health of your eyes.  Ensure that your levels of blood glucose (sugar), blood pressure, and cholesterol are well controlled. You can do this by regular visits to your diabetes nurse, general practitioner or hospital doctor, as well as by having a balanced diet and regular exercise.

Telephone numbers for eye clinics between 9 am and 5 pm:

• Princess of Wales Community Hospital, Bromsgrove:       01527 488198

• Worcestershire Royal Hospital:                                             01905 733569

• Kidderminster Treatment Centre:                                         01562 512382

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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