Since my last blog, I have now decided that the Optos wide-field camera is my favourite specialised equipment that we have in-store.
Yesterday I had a particularly interesting case. It’s always the end of the day, when you’re packing up to go home in 20 minutes, when you get that dreaded call from another optometrist saying ‘I think I need to send this patient to you now‘.
This Optometrist, who knew all about our new technology, did the right thing in ringing me to refer his patient and confirm his diagnosis. We had to decide whether to contact the ophthalmologist straight away or let the patient wait a few more days and this instant referral allowed us to act urgently.
This patient had noticed a black blob in her vision for the last month. In the last few days, she noticed that her central vision had become blurry and she experienced a shimmering of lights. She did not have ‘flashes of lightning’ in her vision or a ‘shower of floaters’ that were typical of a retinal detachment.
I took a scan of this patient’s eyes and within a few seconds I could see exactly what it was – a U-shaped retinal tear. A retinal tear can develop in about 10% of eyes as a result of traction at sites of strong vitreo-retinal adhesions. After a tear has formed, the retrohyaloid fluid has direct access to the subretinal space and can lead to a retinal detachment. This means that the patient is at risk of becoming permanently blind. About 60% of retinal tears occur in the upper temporal quadrant and this was exactly where it was situated for this patient. This is bad news as the tear can worsen with gravity and strenuous activity. I phoned the Ophthalmologist who said they will see her first thing in the morning and she may need to fly to Adelaide for surgery.
This morning I found out that the patient was flown to Adelaide. I truly hope that they can save her vision in time.
Examples like this are a simple reminder that technology like the cameras and scanners are invaluable. You can never put a price on sight!