This was another case of “I don’t feel like filling out forms.” Upon examining this patient’s eyes undilated, Dr. Nguyen asked her if she is hypertensive and the patient admitted to taking hypertension medication. Although not severe, there are enough signs in the eyes to suggest this patient has hypertension.
This patient came in for just an eye exam. In an attempt to make the process go quickly, he indicated he did NOT take any medications. Upon examining his eyes, something was just not right. A huge hemorrhage was found in his right eye and further questioning was warranted.
It was then revealed this patient has been diabetic for over 30 years. In his right eye (the image on the left), you can see a big red dot of blood above the optic nerve (the white dot region). More difficult to see are the other small dot hemorrhages to the right of the optic nerve and some at about 12 o’clock. In his left eye, there are signs of less fresh bleeds (bleeds in the eye behave just like bruises on the skin and as time goes by, the blood fades in color). There are signs of a bleed just above the optic nerve and at about 1 o’clock from the fovea (the dark region of the eye).
Based on this patient’s physical appearance, and because he exercises, takes his medications diligently, and his age, Dr. Nguyen is NOT making any changes to this patient’s care. In fact, he is doing fairly well for how long he has had diabetes. He currently has a low risk of debilitating vision loss. He is being told to visit again in 12 months for a dilation and retinal photos again.
It is important that when filling out patient medical history intake forms to list all medications to the best of your abilities. Contrary to popular belief, some optometry offices do indeed practice medical optometry and are concerned about systemic diseases and their implications to eye health. Morgan Hill Eyecare Optometry practices medical optometry.
Note: Whenever you look at medical images, the images are (almost) always presented to you as if the patient is standing facing you. The right eye will generally be on the left.