Every day, doctors of optometry are responsible for the early diagnosis and treatment of many potentially serious and life-threatening problems. A “routine” eye exam often saves a life. Here are a few of those stories:
A Surprise Diabetes Diagnosis
I have had so many people over the years who I diagnosed with hypertension or diabetes who did not know they had the disease. The one that stands out the most is a patient who was in his late 30’s who came in for a "routine eye exam." He just had a mild prescription and was correctable to 20/20. When I dilated his eyes, I noticed signs of diabetic retinopathy and asked him why he didn't tell us he had diabetes. Although he said he did not have diabetes, I took a picture of his retina and showed him that he did have the disease. At that time, I did not have a blood glucose monitor so I sent him to a primary care doctor, where his blood sugar was checked. It was so elevated that the machine could not measure it. The PCP sent him to the emergency room. After checking his blood sugar there, he was admitted to the hospital to try and bring his blood sugar down and stayed three days to accomplish this. He had no physical symptoms and if he had waited longer to get his blood sugar under control, his outcome would have been much worse.
Diagnosis: Lyme Disease
A 42-year old male came into my office for the first time with complaints of headaches and blurred vision when working with items close up. He wanted an updated glasses prescription. During the examination, I noted that his eyes were mildly red. I asked if this was normal for him and he replied, "No, not really. But I've been dealing with it for the past six weeks. I've tried over the counter drops to ‘get the red out,’ some antibiotic drops from my primary care physician, and even my child's pink eye drops. Nothing seems to be working. I've been feeling lousy...even achy, the whole time." I asked about the possibility of a tick bite. He said, "That's weird. Six weeks ago, I was camping with my family. When we got home, I found a deer tick in my hair. My wife had to remove it from my scalp with tweezers. She threw it away and I haven't thought of it since." He then rather sheepishly pulled his shirt sleeve up and showed me a ring-like rash on his arm. I had him tested to confirm Lyme Disease and he tested positive. His symptoms completely resolved with prompt treatment, which is critical. Patients, especially adults, who receive late treatment may develop chronic musculoskeletal problems and difficulties with memory, concentration, and fatigue. These symptoms can be debilitating and hard to eradicate.
Long Overdue Eye Exam
A 59-year-old male patient had not had an eye exam in “more than a decade.” He was needing new glasses because his very old pair had broken. He was in a hurry and was slightly annoyed that I dilated his eyes because he was going back to work. His vision was 20/20 in each eye with his new prescription for glasses. Upon examining the retina, he had multiple ruptured blood vessels and signs of tissue breakdown in both eyes (e.g. macular degeneration). His blood pressure was slightly elevated, and his blood sugar was so high our machine wouldn’t register a number. I sent him to the emergency department at the hospital next door and he was admitted. He is my loyal patient now and is extremely grateful that I possibly saved his life.
ER Referral to Doctor of Optometry
I was on call at the local hospital and the ER doctor called me early on a Sunday morning looking for my opinion on a 68-year-old female patient. She had forehead and eye pain that started the previous evening. He had performed a CT scan and an MRI of her head along with multiple blood tests and all were normal. He wanted my opinion regarding performing a spinal tap because her pain seemed to be worsening and her vision was progressively getting worse. I was at our clinic, so I suggested she come by for an exam. She arrived with her husband, two adult children and their spouses and her neighbor. They were all extremely worried about her. She walked in with red blisters on her forehead and I sensed immediately she had shingles. Upon examination, she had multiple lesions on her cornea which were causing the eye pain. I started her on appropriate antiviral medication and explained the diagnosis and treatment to her very relieved family.