reflections: THE HUMAN SIDE OF OPTOMETRY
Crossing Boundaries
An encounter with a foreign patient offers special gifts.
BY J. MICHAEL PORTER, O.D.

After several years of practice in a small midwestern community, I'd developed casual friendships with most of the M.D.s who practiced there. But none of them had ever come to me for eye care, even though there were no local ophthalmologists.

I didn't give it too much thought. Instead, I reasoned this was because the doctors were foreign and had been educated in countries that had no optometrists. Another possibility, I thought, involved the legislative wars over therapeutics between us and the medical community, which were then at their height.

A surprise visit

I was pleasantly surprised when one day, our local cardiologist, Dr. Mike (a name that was easier for the townsfolk to pronounce than his Iranian surname), asked me to examine his mother who was visiting from their homeland. She'd had cataract surgery a couple of months earlier in Iran but wasn't satisfied with her vision.

When she arrived at my office a few days later, I was momentarily taken aback. I was unfamiliar with the traditional garb of Moslem women, and Dr. Mike's mom was clothed entirely in black from head to toe, including a black veil. I could see only her grossly magnified eyes behind her high plus spectacles. She could've been any age between 60 and 80. The only hints were her diminutive size, her slightly hunched shoulders, a cane, her careful gait and a soft, aged voice.

Enchanting tongue

Because she spoke no English, Dr. Mike had come to translate for us. I'd used translators many times over the years with non-English speaking patients. However, her whisper-soft, sing-song speech of such an exotic language was enchanting to my ear.

As her son translated, she described her brief post-operative care after her cataract surgery. She'd simply been handed a pair of glasses out of a box and a bottle of eye drops (presumably an antibiotic) and sent home.

During my exam, I found the lensometer reading on her glasses was +10.00D in each eye with a pupillary distance (PD) of 70 mm. Her actual PD was 64 mm, and the final prescription was on the order of +13D or +14D with a diopter of astigmatism in each eye. This combination yielded a crisp 20/20.

I fitted a trial frame with her new prescription. Then, as she watched the eye chart, I had her remove her Iranian glasses, and I quickly replaced them with mine. She stiffened, gasped sharply and began a sort of chant that was so loud I jumped in surprise.

I asked Dr. Mike what was wrong. He just chuckled. "My mother is praying to Allah that you live one thousand years!" he said. Obviously, the glasses offered a vast improvement.

Exchange of gifts

That visit took place nearly 20 years ago and was the only time I ever saw Dr. Mike's mom. This sole encounter reinforced the power of what we do each day for our patients. Our expertise as optometrists transcends boundaries and languages.

The custom glasses Dr. Mike's mom chose took a week to fabricate. Having returned to the land of the Ayatollahs, she wasn't available for proper dispensing so Dr. Mike mailed them to her in Iran.

In subsequent mailings she said she was doing well with the glasses. In return, I told Dr. Mike to let her know that her prayer was still working. 

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