both macula "slightly redder" than surrounding tissue - worried about Tay-Sachs

[Wundergecko]

Hi,

I had a sight test & eye check today (in the UK) and the optician asked if anyone had ever before said that my maculas were red. I said no and she said that they were just very slightly redder than the rest of the eye. Both maculas (maculae?) are apparently this way. She said she thinks it's just anatomically the way I am, and that since both are that way it's nothing to worry about. If only one had been that way she would have referred me on to see a specialist.

Of course, having had many eye exams over the years since childhood (I'm 27) and never having had any comment made about the maculas before, I did some Googling. I'm a little bit concerned now after reading that reddened maculas can indicate a lipid storage disorder such as Tay-Sachs. But that's all I can find about red maculas, apart from retinal artery occlusion which it can't be (vision is perfect apart from the usual nearsightedness which has not deteriorated since last year). I would be very grateful if anyone has any insight into whether I need to follow this up.

[John C Hagan III, MD, FACS, FAAO]

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[Wundergecko]

Standard eye care is different here, yes, and I can't pretend I wouldn't rather see a medical doctor with an interest in vision rather than a dispensing optician.

However, eye tests etc. are not part of the National Health Service, which is fantastic. I was extremely skeptical about it when I moved here, but after five years of using the NHS (and 3 uncommon, specialist-diagnosed chronic illnesses later) the lack of this type of system in the US is one of the main reasons I'm unsure about moving back.

If I were concerned enough about this macula thing to go to my doctor about it, it would be completely free. If necessary, he or she would refer me to the eye hospital - again, at no cost to myself (AND based on clinical need only, not funds available to the doctor). And I pay no more tax here than I would in America. Not something I would be happy to give up.

[John C Hagan III, MD, FACS, FAAO]

Yes things are "different" over there.

Yesterday I had an eye problem myself. I was seen by a retina MD, had a OCT, Fluoroscene angiogram and was treated all in a 3 hours single visit.

JCH MD

[Wundergecko]

FYI for anyone else with similar concerns who may come across this thread in the future:

http://bjo.bmj.com/content/65/3/184.abstract

Basically it says that a guy with Crohn's disease had something that looked like cherry red spot while on IV nutrition and with copper & zinc deficiencies, and that it then went away. I've recently finished a course of antibiotics for tonsillitis and am still having digestive problems, so although that's pretty far from having Crohn's and being fed via IV, chalking this up to temporary gut problems is way more comfortable than thinking I may have a lipid storage disorder. I'll stick w/ this theory till I get the issue followed up.

[Wundergecko]

Thank you very much for your response - I think I may get checked again in a month or two by someone else to see what they think. I know it's very unlikely that I'd have late-onset Tay-Sachs or another lipid storage disorder, but the red maculas thing seemed like such a specific finding that I wasn't sure if I should be concerned.

I'd like to see the equivalent of the eye doctor (MD and various other quals) I saw in the US, but it's different over here...those with that much training are usually based in hospitals, not in their own practices. Hence the 'optician' thing...I believe you can become qualified for this in a 2-year stand-alone course. (Not that I have yet had a problem with the eye care received.)

[John C Hagan III, MD, FACS, FAAO]

Tay-Sachs is unusual, usually bilateral, appears early and has a hereditary basis. HOWEVER you will need to work this out with the "optician" since its their comment.

The cherry red spot of arterial occlusion is associated with very poor vision.

JCH MD