Work-up and Wait

A 54-year-old female presented to the emergency room with a new onset of painless vision loss in her left eye. She stated that she noticed a shadow in the upper left quadrant of her left eye about one week ago. She has a history of an overactive bladder and three months prior was started on Myrbetriq (mirbegron, Astellas Pharma); however, she was then switched to Vesicare (solifenacin succinate, Stellas Pharma) as the Myrbetriq caused headaches. 

The Dangers of DNR

A 62-year-old Caucasian male presented to our office with concerns about his changing vision. Years before, he had a melanoma in his right eye, which was irradiated and treated with plaque therapy. He noted gradually changing vision in both eyes, and that prompted him to see another optometrist in the area earlier, but that doctor said that he “had too many things going on” and referred the case to a glaucoma surgeon. The patient found his way to me first, and it’s a good thing he did because, despite the many factors complicating his glaucoma, he wasn’t yet a surgical patient—so why send him to a surgeon?

A Case of Pediatric Prescribing

In our last installment of this column, we presented the evidence base and theoretical foundation for our approach to prescribing for young children. Now, we give an example to illustrate the points we have covered thus far to help you put them into practice.

Back on the Horse

A 57-year-old black female presented for an eye examination with a chief complaint of near blur. She explained she had lost her job two years earlier and, with it, her vision and health insurance. She had no history of previous ocular or systemic disease, took no medication and reported no allergies.