From the AOSA

Put Mom in the Chair

By Elizabeth Turnage, AOSA Treasurer, SCO

There are many things to think about when seeing patients—did you make the patient comfortable, did you address the patient's issues and concerns, did you diagnose the patient correctly—the list is extensive. I recently had a discussion with my externship preceptor, and his advice was both helpful and simple.

Your patient walks in and has the strangest looking circular corneal ulcers you've ever seen. There are no signs of bacterial infection, no vision loss or redness, but the lesions stain with lissamine green and fluorescein. You aren't completely sure it's herpetic stromal keratitis (HSK), but can't think of anything else it could be. When debating what to do, imagine someone you love in the chair. How would you treat them? Would you treat them? These questions raise two very important points: 1) Always justify your diagnosis and treatment plan; 2) Stay within your comfort zone.

Once you've decided it is HSK, you must determine the treatment course. Be sure to substantiate your treatment plan. If you would or wouldn't do something for your mom, follow the same protocol.

Once you've rationalized your diagnosis, decide if you're comfortable treating that patient. If you aren't, don't treat. If you think about your mom having the same ocular presentation and you lose confidence in your diagnosis, don't treat.

It's important that you feel confident in your decision-making and in your ability to handle potential complications that could arise during the course of treatment. If your comfort level changes or you begin to question yourself, make a referral to someone you trust. Your patient will thank you for it! nOD