reflections: THE HUMAN SIDE OF OPTOMETRY
The Gift of Time
An unexpected "intrusion" reinforces the meaning of the holidays.
BY PETER DODGE, O.D.

The phone rang unexpectedly just as I came out of the shower. On the other end of the line, a woman's voice asked if I was Dr. Dodge. I paused before answering. Maybe Dr. Dodge was away from the phone. After all, this was just before 9 a.m. on Christmas morning. Almost involuntarily I heard myself say yes.

"My name is Mrs. Bradley. I'm not a patient of yours. My son, Ben, is seeing spots in front of his eyes."

"One or both eyes?" I asked.

"Both."

As two-eyed spots don't generally indicate a retinal problem, I spied a glimmer of hope that the morning might not be leaving my control.

PHOTO BY PAT SIMIONE

Ben was eight years old, his mom said, and had been seeing these spots for one week. "I took him to our eye doctor last Friday and she said everything was all right. But he keeps complaining, and I'm worried."

"Did you call your optometrist today?"

"No, I'm embarrassed and thought I might be able to get another opinion." I said that I was pretty sure that waiting until tomorrow to call Ben's doctor would be fine. But Mrs. Bradley said she would really feel better if I looked at Ben today.

I told her to meet me at my office at 10:30 a.m. I remembered a colleague's lament over the Internet regarding her consternation with these "inconvenient" holiday intrusions. Fortunately, I live only a mile from my office, which makes a difference.

Meeting Ben

When I arrived, I ushered Ben and his mom into the office. After uncovering the equipment and having them fill out registration forms, I sat them in the examination room.

Ben wore no correction and had seen an optometrist regularly for a number of years. I took his uncorrected visual acuities: 20/40 OD, 20/40 OS. I began to suspect functional hysteria and wondered how I could avoid a lengthy work-up.

Then, instead of using a pinhole, I threw the phoropter in front of Ben, figuring it would give me better control of the environment. Surprisingly, the static revealed -1.00 sphere in each eye. Even more surprisingly, with a quick refraction Ben's vision was 20/20 in each eye. I ruled out hysteria. Could something actually be causing the spots before his eyes?

I asked Ben how long the spots lasted. A few seconds, he answered, for a couple of times a day. I asked Ben's mom if he was under more stress than usual. Yes.

I decided that Ben had nothing organically wrong. His mom noticed the improvement in his vision when I refracted him. By now I'd established a rapport with Ben and his mom.

I suggested that Mrs. Bradley call her usual O.D.'s office tomorrow and say that I saw Ben. I told her to take my prescription and let the doctor use it as a starting point. And I told Ben that the spots would get better whether he got glasses or not.

Gift of time

The appointment ended and I charged $80, which I felt was a good compromise between removing me from home on this special day and the tendency of O.D.s to give their services away. I'd given Ben and his mom the gift of my time on this holiday morning -- one of the most precious and valuable gifts we have to offer. 

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