Optometry

Case history: A 47-year-old patient reported to her optometrist with a spontaneous corneal abrasion occurring upon waking in the left eye. When the patient first opened her eyes in the morning, she described a “ripping” feeling on the surface of the eye and a sensation of the eyelid sticking to the eyeball. The exam showed an inferior, central 2-mm horizontal defect that responded with complete healing within 2 days of treatment with a topical antibiotic. Review of her history, howev...

A recent article in the New York Times highlighted the legal impact of a 2011 Supreme Court ruling on the liability of generic drug makers for damage done to patients by their products. The ruling concluded that generic drug makers are not liable for damage resulting from their failure to warn patients of specific dangers of their generic products. Instead, they may simply copy the warnings associated with the brand name “equivalent” drug. At first glance it seems that a generic dru...

How would you advise this patient?

Case history: A 72-year-old patient underwent cataract surgery using the Crystalens accommodating lens implant (Bausch + Lomb, Aliso Viejo, Calif.) in the right eye with a target of distance vision.

A 67-year-old patient with 20/50 best corrected visual acuity, complaints of glare during night driving and difficulty reading was diagnosed with cataract and referred. The exam also showed fairly dense endothelial guttata, which are excrescences on the corneal endothelium most visible with specular reflection.

A 57-year-old patient with a history of retinal detachment in his right eye developed significant posterior subcapsular cataract 3 months after successful repair of his detachment. He never recalled recovering completely normal vision after his detachment repair. The patient, a classic type-A personality, was very interested in a multifocal lens for spectacle independence and repeatedly asked about this possibility.

As we gain greater understanding of mechanisms that affect corneal health, and awareness of the effect of even mild corneal dysfunction on vision and lifestyle, I believe three fundamental changes will continue to happen in eye care in the coming years.

A 69-year-old patient was referred for complaints of difficulty seeing street signs, problems reading fine print even with reading glasses and a general reduction in visual clarity. The patient also complained of ocular burning and moderate redness. She was diagnosed with cataract and dry eye by her optometrist, prescribed lubricating drops four times a day and instructed in the use of warm compresses and eyelid hygiene before her referral.

In our daily practice routine, we encounter all sorts of individuals with all sorts of styles of communicating. One of our greatest challenges as clinicians is to develop our own style that provides a clear transfer of information in a caring tone that can fit the broad spectrum of individuals we treat. Reading the personality type of our patient and understanding what methods of reasoning and communication are his or her best fit is an art in itself. Many books have been devoted to this subje...

However careful we are with the way we treat patients, all of us will occasionally encounter someone who is unhappy with our care. Here is a list of principles from a variety of experts that will serve you well in helping your own patients.

Eye care professionals tend to be a very satisfied bunch, rating our happiness with our career among the highest of all professions. Why? Partly because we get constant positive feedback from our patients on how we genuinely benefit their lives. Who doesn’t enjoy seeing patients with newly clear vision?