Practice Pulse: Management Tip of the Month
What You Really Mean
By Mark R. Sukoenig, O.D., Syracuse, N.Y.

We all have our own style for communicating with patients. But, after many years in practice, I've found some key methods for breaking down complex ophthalmic terms or procedures into simple descriptions so that patients can understand what I mean or why I'm doing what I'm doing.

The following descriptions have helped eliminate those blank stares I used to get from patients. Try them on yours.

• The lenses in your eyes are a little like the white of an egg. They're clear, soft organic tissue. Your lens bends to change your focus from far to near. As we age, our lenses change much like an egg white changes when you cook it -- they harden and turn opaque. By age 65, the lens in your eye is usually as hard as glass. As for turning opaque, like a hard boiled egg white, we'd all get cataracts if we lived to age 200. If your lenses get cloudy enough to bother your vision, then we say you have cataracts. A little clouding that doesn't disrupt your vision isn't a cataract, though.

• At about age 42, most people will come to their eye doctor with "perfect" distance glasses or "perfect" eyes complaining that their "arms are too short" to use to read. This happens because their lenses just won't bend much anymore. That's why we now have glasses that change the focus gradually from far at the top to very near at the bottom.

• You can't make a mistake reading the eye chart during an eye exam. What I'm asking you to do is to tell me what the letters look like to you. Whatever you tell me is correct.

• If you're looking at a "C" and tell me it looks like a "G," I'll know that you're really close. If you tell me the letter looks like an "M," you're not wrong. You're just telling me that I'm not finished selecting your best lenses.

• If I ask you, "which is better, one or two?" and you're not sure, that's o.k. That's actually the answer I'm looking for.
  Sometimes, it'll be easy for you to tell which is better. I'm trying to find the point at which it's hard to tell the difference.

• If I'm changing lenses really fast, it's not because I'm in a hurry. I don't want to give you time to strain to focus your eyes. I want the lenses to do the work. If you're straining here during the exam, you could end up straining the same way in order to see with your new glasses.

• Let's pretend I'm Regis, and you get a million dollars if you read the next six-letter line in 4 seconds -- and you don't even have to get them right. Just read them fast and out loud. Now I'll show you the line. (This often shows over-accommodaters that they get everything right when they go fast, and miss when they slow down and start accommodating.)