One of the things that bothers me the most about getting examined by a doctor is the silence. As the doctor, I know that sometimes silence is necessary in order to absorb what I am seeing and carefully observe the results of the test I am performing. But as the patient, the silence can be terribly intimidating, to say the least. I am a firm believer that informed patients make the best patients and have the best outcomes, regardless of the ailment, sickness or condition. With this in mind, I do my best to explain what I am doing at each step of the way so that parent and patient know what is happening.
It was these thoughts that gave me the idea for the following series of blog posts. De-mystifying the exam. Without further ado, lets get started.
Part 1: Medical/Ocular History
In optometry school, we spend a lot of time learning about how to ask questions. When you come in for your examination, I will ask you all kinds of questions, ranging from what medications you take to what you are doing when mom notices your left eye drift out. Every small bit of information that I can get about how you function, how you use your eyes, when you use your eyes the most, when you need your eyes to work the best and what kinds of activities you like to do helps me make a better diagnosis and treatment plan. In school they told us that a good case history (all of those incessant, but vitally important questions) tells us the answers. The exam findings just back up good deductive reasoning based on a solid recounting of the situation. The first time I heard that I was skeptical, but these days I am a believer. It makes me feel a bit like Sherlock Holmes.
No detail is too small–the visual system can be affected by outside stress, emotional stress and everything else we encounter in life. Don’t be afraid to tell the doc something you think is having an effect on how you use your eyes. Systemic health is also important–do not discount the effects that diabetes, high blood pressure, auto immune disease and countless other conditions have on your ocular functioning.
I could go on and on about medical history and its importance, but nobody wants to read that! Not even me. Stay tuned for more information about visual acuity–what is it, how do I do it and my favorite…..how do you get acuity on babies?!?!?