General Information for Opthalmology Patients
Posted , 7 users are following.
I want to pass along some information that may be of help to those with eye issues, but it also applies to medicine in general. This is applicable only for those in the USA. I can't speak to Canada or the UK. For general eye issues, such as when you go for a regular eye examination, see a general opthalmologist. I would advise seeing an M.D opthalmologist, not an optometrist (O.D.) Optometrists can check you vision, but cannot do surgery, and although in many states that can treat diseases and prescribe medications, I think opthalmologists are better trained for this.
Within opthalmology, there are several sub-specialties .
For retinal and macular issues, see a fellowship trained Retina and Vitreous Specialist
For cataract surgery, see a fellowship trained Cornea and Anterior Segment Specialist
For eyelid surgery, see a fellowship trained Oculoplastic Specialist
For pediatric issues, see a fellowship pediatric opthalmologist
For glaucoma issues, see a fellowship trained glaucoma specialists.
Unfortunately, all these specialists are not available everywhere. Sometimes only a general opthalmolgist is available. But you will be better served by being treated by someone specially trained and experienced in a particular area. This applies to all areas of medicine. I recently had hand surgery. I could have seen a general orthopedic surgeon, but I chose a fellowship trained hand and upper extremity surgeon.
Get a second or third opinion if you can. Google your issue and read medical journals online.
Be informed. Ask questions. Be assertive. Medicare and private insurance reimbursements have not kept pace with inflation. Doctors are under increasing pressure to get patients in and out quickly.
Also, it is very difficult for patients to win a medical malpractice lawsuit.
0 likes, 7 replies
RonAKA johnman
Posted
In the part of Canada I am familiar with it, it can be difficult to get into see a specialist directly. For cataract surgery one generally has to see an optometrist first who will in turn refer you to an ophthalmologist that does cataract surgery. That is where it starts to become tricky. The optometrist may refer you to a surgeon that only does basic lenses fully covered by healthcare with little to no choice on the brand of lens. Or, they may refer you to a surgeon that pushes one brand or another of premium priced lenses. The point being that once you have "picked" your surgeon you may have picked the brand or type of lens you can get.
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The best strategy is to do a bit of research and find out what type of lens you are interested in, and request that you are referred to a surgeon that does that lens. The hope is that the optometrist will be familiar enough with the surgeons to know what they do and don't do. One option would be if you get referred to a surgeon that does not do your lens of choice, ask that surgeon to refer you to one that does. Ethically they have obligations to do that. Yes, it is a clumsy system! It can be worthwhile to check around with seniors that you know have had cataract surgery to find out what lens the got and where they got it.
Beth-R johnman
Posted
Johnman,
I am in the USA on Medicare with a supplemental plan. My Optometrist referred me to the Ophthalmologist who did my cataract surgery on both eyes. I had 3 follow-up appointments in the first month following each surgery. I saw my Retinologist (Ophthalmologist) a month following the first surgery. After 6 months, I saw my Optometrist who gave me a more thorough exam and more information than either of my Ophthalmologist specialists. I have found that the specialists don't want to spend extra time explaining things and answering a bunch of questions. My Optometrist has always been a powerhouse of information and never rushes me through an appointment. All the doctors have their purpose and I trust all of them. I go to five physicians and three are for my eyes.
Yes, people should do their due diligence, but not all people have or know how to get the resources, other than friends who refer them to a physician they have used. I know people who are elderly and don't use the internet. And for people who do use the internet don't always know how to filter the good info from the bad info... just because it's on the internet, it doesn't mean it is reliable.
johnman Beth-R
Posted
Beth,
I'm glad you like your optometrist, I used to see an optometrist until he said I had early macular degeneration. I saw a retina and vitreous specialist who assured me I did not have AMD. He recommended I see an opthalmologist, which I continue to do. I have a small cataract and I saw a cornea and anterior segment specialist who gave me quite a thorough exam and told me my right eye was dry and to use non-preservative artificial tears. Optometrists are generally not as busy as opthalmologists and should be able to spend more time with patients. It just depends on the individual eye doctor.
You're right about how most people get their information--from friends, which arern't always the best source, but that's all they have. I have worked in healthcare since 1977 as a patient care technician,, respiratiory technician, surgical technician and orthopedic technican. I am also a Legal Assistant for a law firm that does a lot of medical malpractice defense. We defend physicians and hospitals. Some lawsuits are frivolous but many are not. Mistakes and errors are made. I have witnessed them. I have heard doctors admit them, or heard nurses talk about them. As a Legal Assistant, I have reviewed medical records and have read how things went wrong.
Even the most reputable physicians may differ on diagnosis and treatment. Many years ago my mom's internist diagnosed her with an incisional or ventral hernia. He said she could probably defer surgery. I took her to two general surgeons, both of whom advised surgery. I then took my mom to a hernia specialist at a medical school who agreed with my mom's internist that she could defer surgery. She lived with that hernia for 15 years and passed away from dementia.
The internet can be good source of information, but yes, it requires discernment. One opthalmologist was going to do cataract surgery on a friend of mine who had 2 diopeters of astigmatism. He recommended Limbal Relaxing Incisions for the astigmatism. I did some research (medical journals) and found that for that much astigmatism, toric lenses are better. My friend saw another opthalmologist who fitted him with torics.
I have tried to assist family, relatives, friends, and the general public whenever I csn.
Sue.An2 johnman
Edited
Live in Canada - you ate lucky in USA if you can see those kind of specialists whenever you want. Here - and depending which province you live in it is a lengthy wait. My optometrist diagnosed me epiretinal membrane and it took 18 months to see our 1 retina specialist. And even after that visit if surgery needed I would need to travel to another province for it.
Bookwoman Sue.An2
Edited
Ease of seeing specialists is one of the good things about US medicine...if you have good insurance (and of course that's a big 'if'). When I developed light flashes and some floaters in one eye a few months after my cataract surgery, I saw my ophthalmologist - who was also my surgeon - the same day I called him. He ruled out a retinal detachment, and got me an appointment with a retina specialist 48 hours later. (It turned out to be PVD, and the floaters eventually dissipated.)
For the haves, our system works very well. For the have-nots, it's a different story.
johnman Bookwoman
Posted
Bookwoman
Your last sentence summed it up very well.
Sue.An2 Bookwoman
Posted
Not sure there is a good or perfect system. We recently in our province had 2 deaths of people waiting in emergency. Waits are way too long and once triaged you could be sitting there 15 hours. Have or have nots wait.