Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision.

BLOG: How's your general health and fitness?

For many years, a standard question in my optometric history has been: “How’s your general health?” This always prompted a discussion about diabetes and blood pressure, as well as a host of general health maladies.

In this new era of health care reform, the age-old question must go deeper. With an emphasis on wellness and prevention and the new role of the optometrist as an essential member of the primary health care team, we need to go further than the immediate health of our patients. We need to be concerned about the physical fitness of our patients.

I believe it is my role as a low vision optometrist that has made me passionate about this subject.

Just this week, I sat facing a patient that was younger than I, but had clearly traveled a rougher road. He was a lifelong smoker and had been diagnosed with diabetes only after multiple system failure. He was missing a leg, on dialysis and had undergone lensectomy, vitrectomy and panretinal photocoagulation. Although I could help improve his acuity a bit and re-establish reading with magnification, he was not a “reader,” and my help at this point in time was not going to have much effect on his quality of life.

His daughter went on to lament that he and the family had no idea that diabetes could cause these types of serious problems. It had been a family joke that he was the healthiest diabetic in town. He didn’t need to go to the doctor because he felt great. It all went downhill so fast over the past few years.

Although there was not much I could do at that point, I wondered: What if I had seen him as a primary care patient when we both were young? What if I could have educated him on smoking and diet? Could I have done a better job to improve his long-term quality of life?  Maybe. I wish that I had had the chance.