Strangest patient consultations
Jason Higginbotham
Experienced consultant to ophthalmic practices, clinics, device manufacturers, suppliers, developers and academia. Optometrist and Dispensing Optician.
Over the years, when I was a full-time practising optometrist, I did many domiciliary visits. I met some very interesting and intriguing eye examinations.
Recently, I was reminded, during a conversation, about one of the more challenging and peculiar eye examinations I ever conducted.
I was visiting a care home in Manchester which housed men with a range of special educational needs (SEN) and challenging behaviour. I always enjoyed the challenge of trying to give them as close to a full eye examination as possible. Often, this was indeed possible. Sometimes, however, it was not!
After seeing several patients at this home, I was advised that one more had returned from what they called 'day college'. This gentleman lived in a separate apartment below the main home and always had two carers with him. He had a severe form of autism and was non-verbal. He was, from memory, in his early twenties.
When my colleague (a male optical assistant) and I got to the apartment and began to set up our equipment, the patient went into his bedroom. We waited some minutes for him to return.
When he did come back into the main living room, he was completely NAKED. The two male carers who were present laughed and informed me that he always did this. The patient promptly walked into his bathroom and stood there with a benign and content look on his face.
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I realised I would need to improvise!
I took some trial lenses, my retinoscope and my ophthalmoscope into the bathroom.
I'm not the tallest of people. This young man was about six feet tall. I did all I could, whilst on tiptoes, to conduct fundoscopy, whilst being ever vigilant to avoid, shall we say "contact"!
My colleague did all he could to avoid bursting out laughing as I struggled to get a good view of my patient's retinae whilst balancing and keeping a reasonable distance from the patient. Retinoscopy was, thankfully, much easier. I was glad there was little spectacle prescription as it was almost certain the patient would not have worn spectacles and I was glad he likely had good functional vision.
It may also have been a challenge for whomever came to fit any spectacles!
I'd be interested for other clinicians to post some of their stories on their most challenging consultations.
Freelance Optical Trainer
2 个月As a practice manager some years ago I had an concerned patient come out of the test room and informed me the optometrist had not spoken or moved for 10 minutes…on investigating the issue he had fallen asleep at the desk…turns out he was working full time and studying for a masters..burning the candle both ends ??
BSc Hons MCOptom Prof Cert Medical Retina
2 个月During my pre reg I had a young girl have a full seizure during her test - unfortunately the girl was terminally I’ll with a brain tumour and her mum warned me that this may occur I also had a lady in practice who all the way through history and symptoms kept referring back to her main issue that her bifocal segment was too low. I told her that we could sort that out at dispense and she looked me in the eye unblinking for a full 20 seconds -I thought I’d really annoyed her until she slipped out of the test room chair unconscious and urinated on the floor - paramedics promptly called and whisked off the hospital - she returned a few weeks later to tell me all was ok - she’d probably over medicated accidentally Thankfully my nurse training prior to my optometrist training came in handy on both occasions
I am now retired but I recall one particular visit to a care home . An elderly lady came to see me in the room I was using for eye exams and after testing her eyes I turned away to fill out her prescription. When I turned back to face her she was rolling down her stockings. I asked her what she was doing and she said "don't you want to look at my feet? You are the chiropodist aren't you !!!
Director at Davis & Samuels Ltd
2 个月I had a patient die in the chair during a sight test. Somehow the local press found out about it and was reported in the local newspaper as “no suspicious circumstances”!! Very soon after newspaper article I did a domiciliary visit at an elderly lady’s house. The daughter was present. Halfway through the test the patient stood up and started shaking violently. The daughter holds the mother - the shaking was so violent they both started shaking at which point the daughter says “Are you the Optician in the newspaper?” Next day a man has an epileptic fit in the practice and fits on the floor. Called 999 - was the same crew that took the deceased lady away - one of the crew said “not coming here to get my eyes tested.”