To read part five first, please click here.
During my journey to my diagnosis of acute zonal occult outer retinopathy (AZOOR), I was called in for a fundus fluorescein angiography (which is easier if we just call it an FFA!) and an indocyanine green angiography (ICG) and it was one of my stranger appointments, but definitely not the worst.
I work at an eye hospital and we usually complete FFA tests for patients with incurable retinal problems, so by the point this test was suggested, I had already resigned myself to it confirming that the poor back of my eyes weren’t doing what they were supposed to!
You can Google quite a lot of information about FFA tests and most of what I’ve found is really accurate. If you haven’t heard of it before, it is an infection of a dye into your bloodstream by a cannula, as you have a scan on the back of your eye with a medical photographer, to see how the dye fills your eye. It tests your blood flow to the eyes. The ICG shows the blood flow in a part of your eye called the choroid, under your eyelid, and this is done as part of the same test.
What To Expect Before..
My FFA/ICG was booked as urgent, so I had a phone call from a nurse immediately after I had the call from the bookings department to make the appointment and I had my pre-assessment over the phone. Strangely, I was asked if I was allergic to shellfish.. Apparently, there is something in the dye that can cause the same allergic reactions as shellfish! I was also asked about medications I take, if I was pregnant and if there were any other health conditions they should know about. This was exactly the same as my hospital records from a few weeks before, so only took several minutes. I was made aware that I might feel unwell during, or after the test, so was posted out an information booklet with my appointment letter, but I did know plenty about the test from work already, so didn’t have any questions, which definitely cut the phone call time down, but I’m sure the nurse would have stayed on longer had I needed. The evening before the appointment, and the morning of, I drank a lot of water, like you should always do before a blood test, to make it easier for the nurse to get the cannula in to my hand.
What To Expect When Being Admitted..
I have never had a daycase appointment where I’ve admitted myself – I have always ended up in hospital unexpectedly, or only attended for routine outpatient appointments that have lasted a couple of hours. I was allocated a bed and my next of kin was triple checked, because apparently a lot of people get sick during a FFA tests! I had my blood pressure done and my eyes were dilated with drops, whilst a nurse talked me through what was going to happen and the common side effects – sickness and dizziness. A cannula was then placed in my arm, after a couple of failed attempts to get it into my hand! I had drank plenty of water, but it was pretty cold on the ward and I guess my veins just didn’t want to be agreeable.
What To Expect During..
After about an hour and a half, I was called into the medical photographer’s room and sat down at the table with the photographer and a nurse. I looked into a couple of the different machines and had some scans done without the dye, before the nurse injected both dyes, one at a time into my cannula and more photos were taken as the dye reached the blood in my eyes.
Apparently, the dye filled my eyes super quickly, which is a good sign. The actual scans were over in about ten minutes for me, but if the circulation in your eyes isn’t as good as mine, it can take longer. I didn’t feel sick or light headed during the scans at all, but it was a very strange sensation to have the dye being injected into the cannula!
Straight after the scan, in the photographer’s room, the nurse removed my cannula and I was taken back to the ward, given a glass of water and monitored for fifteen minutes before I was discharged from the hospital. If I had been feeling unwell, I would have needed my next of kin to pick me up. As my eyes had been dilated, I was allowed to get home myself, providing I wasn’t driving – so public transport and taxis are allowed..
What To Expect Afterwards..
My vision was still pretty blurry after the test, but other than being just tired from a two hour hospital appointment, I felt fine. However, one of the guaranteed side effects of an FFA is for the whites of your eyes to look yellow and also for your urine to be very yellow too. The FFA dye was yellow and the ICG dye used was green, for lack of a better way of saying this, my wee was fluorescent, hi-viz coloured, ‘glow in the dark’ yellow. Immediately. For about three days afterwards, whilst my eyes looked back to normal by the next afternoon. Am I really posting about my pee on the internet? Yes.
I got the results of my FFA and ICG about a week later and they confirmed the diagnosis of my rare retinopathy. It was an almost painless procedure (damn that cannula!) and I wouldn’t complain if I had to attend again.. and at least this time I would be prepared for the highlighter coloured urine!
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