This is just a quick post inspired by a lovely lady I met yesterday.  Mrs C has geographic atrophy at both maculae and is now registered partially sighted.  She popped in to see me for a chat.

Mrs C has been attending HES but, at the last visit, the doctor told her there wasn’t anything further they could do.  He had mentioned an operation (privately funded) but, at the time, she didn’t feel comfortable asking questions so here she was, on a rainy afternoon, hoping I could clear a few things up.

We spoke about the implantable mini telescope which is being offered privately to AMD patients.  She didn’t like the idea of surgery, having had right phako that didn’t improve her vision.  She also didn’t like the price (I don’t think anyone does).  I explained that it wasn’t a treatment as much as a built in magnifying lens that could also move the image out of the affected area of the retina and into an undamaged part.

Although she didn’t fancy the surgery, we had a great chat.  Mrs C is one of our patients with Charles Bonnet Syndrome but she’s unusual in that she sees buildings instead of people or patterns.  We talked a bit about that and I described some of the experiences my other patients have had (see my previous post on Charles Bonnet for details).

She also described getting a fright at the hospital when, after Volk, the consultant had turned blue.  Although he explained that it was the bleaching of the photoreceptors, she was still quite upset and wanted reassurance that it was normal.  I’ve had the same experience myself after a fundus photo, although the world turns purple in that case (at least for me).

Finally, I got onto magnifiers.  I asked if she had some and she said she just had the one.  It was a small, illuminated Eschenbach handheld magnifier and Mrs C complained that she very rarely used it, finding that she had to rest it on the paper she was trying to read (which isn’t ideal as she needs it for prices, labels, etc when shopping).  I discovered that she was using it with her reading glasses.  It had been 2 years since she’d been seen at a low vision clinic and obviously she’d forgotten that she needed her distance glasses on for it to work.

I asked her to try it with her distance specs, resting the magnifier on the paper to start and then bringing it towards her eye until the letters were clear.  That was much better.

The small magnifier is ideal for when she is out and about but we’re getting in a selection of illuminated stand magnifiers for her to try as Mrs C mentioned that it would be nice to be able to read her mail (her daughter is on hand to help usually).  I explained that the stand ones need her to use the reading glasses.  Her near visual acuity is N24 so I’ve asked for 4x magnification if possible (4x would have her reading N6 with difficulty but N8 a bit more fluently).

If you are a pre reg,  I’d recommend looking at the Eschenbach catalogue to get an idea of what is available for our VIPs – but remember that a good magnifier can easily cost £80+.

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