THE CASE HISTORY - Am I getting a good eye exam? 

by Gabe R Monday, May 02, 2011
How does the average person know they are getting a good eye exam? This is an insider’s point of view, an abridged version, and we’ll start with the CASE HISTORY. It’s the case history that drives the rest of the exam.

After being greeted by the doctor – or her assistant – you’ll be asked about the main reason for the visit, aka the chief complaint, along with follow up questions that break down your problem into pieces . . . like onset, duration, aggravating factors, is it getting better or worse, any previous episodes? Since people have varying lifestyles, it is likely that you will also be asked about your visual demands . . . like how much time do you spend in front of a computer, is it a laptop or desktop, do you like to spend a lot of time reading, playing video games, etc.? And since your eyes are but one component of your whole body, it is likely you’ll be asked about your overall health condition, medications, family history, and who is your primary care provider (in case further communication or consultation is needed)?

Not only are we gathering facts, but a good clinician, consciously or subconsciously, is also making gross observations about things like the patient’s overall state. Here is an example, an excerpt from my blog.

True story: In early November, 2007, a 49 year-old Asian male, J.G., walked sluggishly into Optometry by the Bay. It was close to noon. He had recently noticed some blurred vision, was having some headaches and generally felt weak. It turns out that he was also a martial arts instructor in generally good health.

Something about him just did not make sense to me. Most martial arts guys I knew – especially instructors – were usually full of energy and enthusiasm ala Jackie Chan movie bloopers, but J.G. was the complete opposite that morning.

Among other findings, his vision was not correctable to 20/20, and his pupils were not quite reacting the way they should. After taking a close look at his swollen optic nerves, I took digital images of them, carefully explained to him what I was seeing, and sent him straight to an ER. Two days later, he had a golf-ball sized tumor removed from the right side of his brain. Two weeks after that, J.G. walked into my office – aided by his son. . . . big smiles on both faces. His head was shaven and a bandage covered the staples in his scalp. He and his family “just had the best Thanksgiving – ever.” I’ve been lucky enough to see J.G. every six months, and I’m happy to say he’s got his swagger back and is doing very well.

It was during the case history that I knew this would be more than just a routine eye exam. So, it helps the eye doctor if you could be a good historian about your chief complaint, medical history, and visual demands. Likewise, it helps you to have an eye doctor that is highly skilled at listening, observing, and asking the right questions. With a thorough CASE HISTORY, your eye exam is off to a great start!

If you looking for an Optometrist in Hercules CA or an Eye Doctor in Pinole CA don't hesitate to Optometry By The Bay!

General | Categories: health
0    submitted by Gabe R
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