It’s Only Routine Until It Isn’t

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Nearly 96 percent of the respondents to a recent Women In Optometry Pop-up Poll said that they’ve made at least one life-saving or sight-saving diagnoses during a routine comprehensive eye exam. Thirty-two percent of the respondents said that it has happened at least once, while another 31 percent said it happens at least once a year and 32 percent said it happens several times per year.


The majority of respondents (53 percent) said that they have been in practice for at least 20 years, with another 21 percent saying they’re been in practice 11-20 years and 19 percent saying they’ve been in practice five to 10 years. About 8 percent said that they’ve been in practice fewer than five years. Most of the ODs who said they weren’t sure or hadn’t yet made a life-saving diagnosis have been in practice fewer than five years.


Many respondents added at least one example.

“I have diagnosed cases of advanced glaucoma (at time of diagnosis), retinitis pigmentosa, and diabetic retinopathy in many situations over the years.”

“I saw a past patient who complained of decreased vision ou that had started the same day he came in. The DFE showed a white substance moving about in his vitreous. I did not know what it was so I referred him out to a local ophthalmologist who referred him to a specialist at Barnes. The ophthalmologist promptly called me to say I had saved his life by referring him out. The patient had a systemic infection that was life-threatening. I saw the patient again later who stated he did not remember the ride to Barnes at all and was in the ICU for a week.”

“Malignant hypertension may be the most common life-threatening finding, frequently with the patient asking when blood pressure testing became part of an eye exam.”

“Many patients have been caught in a hypertensive crisis. Actually had an ER doc call our office to thank us for saving a patient's life!”

“Found a brain tumor in a 6-year-old.”

“I just had a patient with aphakia ou who came in for a routine eye exam. She complained of pain in OD sometimes. The lens came out of the sac wand the lens leg was scratching cornea from the inside. Patient had IOP very low and leucoma was forming, patient ended up with a corneal transplant.”

“I saw a retired Navy pilot for his first civilian eye exam upon retiring. He described how he had started having difficulty passing his flight physical eye exams the last few times. I asked if they provided him any additional testing, and he replied no because he was nearing retirement. His confrontational fields were restricted. Because his complaints were so long-standing, I skipped a visual field and ordered an MRI. He had the largest benign pituitary tumor his neurologist had ever seen. Neuro was happy it was benign, but told the patient to thank me for saving his life. The tumor was so large it was pressing against his carotid arteries, and he was told he could have met his demise at any moment. This very grateful patient sent me flowers.”

“Pseudo tumor in multiple patients (including twins) secondary to BCP Patch, new cases of glaucoma about 3-5x/week.”

“Brain tumor pressing on optic nerve/chiasm, multiple sclerosis, retinal detachments, proliferative retinopathy, multiple hemorrhages in same eye, severe herpes keratitis,...”