July 13, 2005 (I checked his chart), I remember examining my buddy, Dave, near the end of the day. He complained of blurred and distorted vision in one eye.
As doctors, through careful questioning, about 90% of the time we know, or think we know, what’s going on before we ever examine the patient. I knew my buddy had Idiopathic Central Serous Chorioretinopathy (ICSC). I had seen it before in another friend.
me: “Dave, I think I know what’s going on. Any extra stress in your life lately?”
Dave: “I’m not sure, not really…”
me: “Well anyway, I think I know what’s going on, but let’s get you dilated and take a look.”
Dave had active inflammation in one macula and suspicious lesions in the other. However, he did not have ICSC. The diagnosis was easy once I looked…he had Presumed Ocular Histoplasmosis Syndrome (POHS).
Dave’s story sticks in my mind because I was near tears when I gave him my diagnosis. I referred him to a retinal specialist and I knew that he would get laser treatment and would eventually be one of my low vision patients. But his case also sticks in my mind because there was something I didn’t know…
Rather than using a laser, the retinal specialist reported that he had injected a new cancer medication, Avastin, into Dave’s eye. Whaaat???!!! How would this help save his vision? Of course, now we know. His vision did improve and, despite eventually needing injections in both eyes, he still has good vision to this day. Amazing.
I believe there is a corollary here with low vision care:
There are new and unimaginable ways to help patients see better or even use other senses to complement poor vision. There are also often ways to acquire funding for expensive devices and to overcome other perceived obstacles.
If not me, seek another effective low vision provider via a Google search or other means. Low vision referral is the Standard of Care for good reason — there just might be some things that you didn’t know that you didn’t know.