reflections: THE HUMAN SIDE OF OPTOMETRY
Reassessing Priorities
Meeting someone less fortunate helped this O.D. re-evaluate the things she took for granted.
BY AMBREEN RASHID, O.D.

Fresh out of optometry school, I worked with two ophthalmologists who, combined, had more than 30 years of experience in a fast-paced hospital practice. As a young female optometrist, I had a drive to prove myself.

One busy day, the receptionist told me that she added a new patient to my schedule. He'd apparently scratched his eye with his hard contact lenses. I expected an easy exam.

More than a scratched eye

Tenan was from Bosnia and had been fitted with gas permeable contact lenses at the local mall. He said that his eyes hurt after wearing the lenses for a while and that when he removed them, his vision remained blurred.

His vision was approximately 20/40 in both eyes and during the slit lamp exam, I noticed deep indentation grooves from both lenses. Upon further exam, I found that he had moderate to severe keratoconus in both eyes. Tenan had high amounts of corneal warpage in both eyes secondary to the contact lenses. His vision without contact lenses was limited so I couldn't take him out of the lenses because he'd be unable to function. I did the initial workup including corneal topography.

ILLUSTRATION BY PHIL HOWE

Fixing him up

During our visits over the next few weeks, Tenan told me that he left his wife and son in Bosnia to make a better life for them here. He also mentioned that only one eye doctor served his area and the waiting list was 6 to 8 months.

My lab helped me design aspheric lenses that were stable on the cornea, had almost no warpage effects and gave Tenan 20/25 vision. I explained to Tenan in detail what keratoconus is and how it could affect his vision in the future. I gave him a booklet and my phone number and had the office set him up for a 6-month appointment. I never saw him again.

Tenan resurfaces

Then one day Tenan called. His Visa had expired and he had returned to Bosnia. His lenses weren't as comfortable as when he first got them and he wanted me to suggest something. I told him to see the doctor in Bosnia, as I couldn't do much without examining him. I gave him my e-mail address and later learned that he was a candidate for a corneal transplant. He decided to stay with his contact lenses for as long as possible to avoid the costly surgery. I occasionally receive a brief e-mail from Tenan -- he's still wearing the lenses that we formulated for him here.

Refocusing

We're lucky to live in a country that has access to some of the best medical treatments in the world. This realization is especially clear when you examine someone from a country where medical treatment is a rare and expensive commodity.

The interaction that we have with our patients extends beyond the exam room. It's our responsibility to treat our patients with the care and understanding that we would expect for our own family. We have the skills to improve the quality of life for many people and that should be what optometry is about and that should be our focus every day when we walk into the exam room.

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH KAREN RODEMICH, MANAGING EDITOR OF OPTOMETRIC MANAGEMENT AT (215) 643-8135 OR RODEMICHKF@BOUCHER1.COM.