Patient education is a large part of our jobs.  It’s not enough to tell someone that they have a cataract, you have to explain what it is and how it’s affecting their vision.  You’ll maybe talk about contrast or glare and offer some coping strategies: good lighting, a backlit screen, sunglasses on a sunny day.  You may talk about referral, what to expect in the surgery and timelines for treatment.  Maybe you have a College leaflet to give patients, to reinforce what you’ve said.  All of this, while a routine part of our day, is a massive thing for the patient and I think sometimes we forget that.

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I think most people have questions about the eye test but they don’t usually get a chance to ask.  Maybe they, like a lady I saw today, have siblings with AMD and bird shot retinopathy and want to know exactly what that means and why they have it (even though the patient herself had completely healthy eyes).  The same patient wanted to know how we test babies*.  All these random questions pop up when you’ve built a bit of rapport.  One lovely gentleman (who was a giant pussy cat despite having the scariest tattoos I’ve ever seen) became a bit fixated** on the little hot air balloon in the autorefractor.  He wanted to know where the picture was taken (he guessed it was America from the road markings, probably Arizona, and was a little disappointed that I could neither confirm nor deny this).

I usually talk my patients through their fundus photo, highlighting the disc, blood vessels and macula.  If there is any pathology, I’ll show it to them.  If they have a family history of glaucoma, I will talk about the disc more or if they have mentioned AMD, I’ll pay particular attention to the macula.

Ideally, we should tailor the eye test based on the specific needs of the patients.

Another part of the job is mythbusting.  I have heard many people tell me they don’t like wearing their prescription glasses too much because they feel it will make their eyes lazy.  For some reason, they think struggling to read is good for their eyes, like a spell on the elliptical trainer is a good workout for your lower body.  It’s mainly middle aged hyperopes that spout this rubbish and it’s usually because they are unsure of why they need reading glasses.  After all, they were fine until a few years ago, perhaps their eyes have become unfit? Also, someone is telling people that they will start to depend on their glasses more if they wear them more.  This has resulted in many middle aged men and women coming to me with asthenopia yet refusing to wear their glasses.  I also get a lot of people asking me if they should wear their prescription all the time.  Unless you need them to drive, pretty much any other time is optional.

Recently, there was a lady in the newspaper *** who claimed she didn’t need specs due to her daily eye exercises.  Now, I did see a lady a few years ago who was R plano L -2.00DS, giving her natural monovision in her 80s.  I can only assume this lady had a similar prescription or that she had grown very good at interpreting blur.  An article like this (or any other high profile eye-related story) is a perfect jumping off point for a discussion of eye health.

 

* In theory: estimate vision, check muscle balance, ret and look for red reflex.  In practice: very quickly and with great difficulty.

**Pun not intended.

*** I use the term “newspaper” loosely because I think the article was originally in the Daily Mail.

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