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  BEST OF “ODs ON FACEBOOK”

A BEAR OF A DIAGNOSIS AND A QUIZ

A LOOK AT TWO STANDOUT CLINICAL CASE STUDIES

ALAN GLAZIER, O.D., F.A.A.O.

WHILE I rarely have “the answers,” I know I can often find them on “ODs on Facebook.”

A MISSION

I encourage people to post compelling cases, in which O.D.s have undertaken impressive feats of medical care for patients. As mentioned last month, these cases are organized with the hashtag #TFT which, when typed into the group search function, turns “ODs on Facebook” exclusively into a list of clinical case posts.

Some of these cases are used at a lecture for Vision Expo called, “ODs on Facebook: Tales from the Trenches,” conceptualized by Mark Dunbar, O.D., F.A.A.O. This year’s Vision Expo East lecture will be moderated by Ben Gaddie, O.D., and the panel will include Dr. Dunbar, Paul Karpecki, O.D., F.A.A.O., Diana Shechtman, O.D., F.A.A.O., Scot Morris, O.D. (chief optometric editor of this publication), and Andrew Morgenstern, O.D., F.A.A.O.

Until then, here’s a look at two standout cases that were recently posted to “ODs on Facebook.”

BEAR TRACK LESIONS

One “ODs on Facebook” member helped save a young woman’s life. She posted that she recommended the patient undergo a colonoscopy due to “numerous” findings of congenital hypertrophy of the retinal pigment epithelium (CHRPE). CHRPE can appear as lesions that look like bear tracks.

A gastroenterologist informed her the patient had Gardners syndrome, or familial colorectal polyposis, which can indicate serious colorectal or skeletal disease.

This post received close to 2,000 likes and 45 comments.

WHAT IS YOUR WORKUP?

An “ODs on Facebook” member recently posted that an 87-year-old white female presented to his practice complaining of a rapid onset of decreased vision OD, which began several days prior to the visit. The post included several fundus photos (including the image below). A positive afferent pupillary defect was noted with acuities of OD counting fingers and OS 20/30.

Fundus photo of an 87-year-old white female who presented complaining of a rapid onset of decreased vision OD

The patient’s medical history was positive for hypertension and cholesterol sans medications (she discontinued them due to intolerance). Blood pressure in office was 148/94, her pulse was regular, ESR was 19 and CRP was 1.9. The O.D. asked, “What is YOUR work up of this patient going to be?”

Responders asked questions about history of trauma and suggested issues with blood chemistry and carotid workups. The correct diagnosis was central retinal vein occlusion, or CRVO, with a risk of glaucoma development.

It’s important to note that the ability to manage conditions like this varies tremendously nationwide due to practice restrictions, but caring for this patient is well within our scope of practice.

This post received 71 likes and almost 40 comments. OM

DR. GLAZIER is founder of Shady Grove Eye and Vision Care, a five-doctor medical-model practice in the Rockville, Md. suburbs of Washington DC. He is an author, inventor, industry consultant and frequent lecturer on ocular disease and Internet marketing. He can be reached at aglazier@youreyesite.com. Be sure to follow him on Twitter @EyeInfo or PM him on Facebook.