Chuckle, chuckle, chuckle, chuckle. |
A single patient walked into my room yesterday who opened up a big can of worms. I knew before going into the room she was using these, thanks to the technician who prepped me. I go into the room to find she has had this "cataract" for about a year, diagnosed by a Wal-Mart optometrist (no exaggeration here). The most s/he said was that there was no view past the lens, so clearly she had a cataract. Her vision is currently in the hand motion range, or worse than 20/1000. According to her, the drop has helped. What??
Things are already sounding suspicious. A hand motion cataract doesn't just pop up over several months to a year, particularly in a woman in the chair who is unusually inert about the whole thing. How could you just let yourself loose so much vision? On further questioning, the patient is found to be a diabetic and hypertensive. She's been diabetic for 20 years and is on no medication. What??? She checks her blood sugar most mornings (and the values she quotes are too high as is), but has no primary care doctor. What????
On exam, sure there are cataracts, but they are NOT hand motion ones, and they are more or less equal on both sides with her other eye being 20/40. RED FLAG - something else is going on. The retina is not at all visible in the hand motion eye. The other eye shows diabetic retinal disease everywhere, though certainly not the worst I've seen. Nice work diagnosing a cataract, Mr. Wal-Mart Optom. I refuse to use the title "doctor" for this individual. She clearly had hemorrhage in the right eye, with 90% certainty it's related to her diabetes. And the fact is, it was probably even easier to see the hemorrhage 9 months ago.
This all brings up several issues addressed in recent blogs:
1. Ophthalmologists are true physicians - I suspected diabetic disease before even looking at her eyes because I TALKED to the patient about her MEDICAL problems. We've done our part trying to get this lady to someone who can help us with the diabetes.
2. Are these optoms the ones you want pointing lasers in your eyes? Although it's possible the patient only heard what she wanted to, she was obviously not given the reality of what was happening to her. I'm also suspicious the optom didn't even dilate her and look at the other eye. Even without dilation, one could easily see her bad eye did not have a hand motion cataract.
A few new issues, at least to this blog:
1. Homeopathy is not good for cataracts. The most those drops would have helped is dry eyes, and even that is questionable at best. Surgery is currently the only help, sorry optoms.
2. Homeopathy is not good for 20 years of diabetes. I asked her if she had been offered treatment for her diabetes in the past, and she said no.
3. So, as Dr. House always says, patients always lie.
4. A passive/alternative approach to chronic disease will kill you, eventually. And it kills me to witness it.
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