Silly things patients do during an eye exam that bug the heck out of me!

[wizer]

I'm examining NH at the moment. NH is a contact lens patient who has been coming to my office for years. Shes an attractive but chunky blonde...anyway, I will never forget the time she came in for a checkup, and said to me.."Doc, you remember when you gave me medicine for my pink eye? Well, it didnt really help, but you know what cured it? My boyfriend came on my face and some of his semen got in my eye and the next day it was all better!".

If she was trying to shock me she picked the wrong guy...LOL...

I told her it was probably just coincidental anyway.

[GoodWitch]

I'm examining NH at the moment. NH is a contact lens patient who has been coming to my office for years. Shes an attractive but chunky blonde...anyway, I will never forget the time she came in for a checkup, and said to me.."Doc, you remember when you gave me medicine for my pink eye? Well, it didnt really help, but you know what cured it? My boyfriend came on my face and some of his semen got in my eye and the next day it was all better!".

If she was trying to shock me she picked the wrong guy...LOL...

I told her it was probably just coincidental anyway.

I can't imagine speaking that way to one of my Dr.'s. That's really skanky, IMO.

[wizer]

I can't imagine speaking that way to one of my Dr.'s. That's really skanky, IMO.

Some of my female patients feel very comfortable with me and tell me LOTS of stuff...and I don't mind hearing about it..LOL...

[wizer]

Pop quiz!

This last patient was a 1 week contact lens followup. She said she was doing really well with her contacts, but on the 4th day after she put them in, she suddenly "couldnt see a god damn thing". I knew immediately what the problem was...and when I told her, she said "no way!". Turned out I was right. This happens at least once or twice a month...even with experienced contact lens wearers.

What happened?

[GoodWitch]

Pop quiz!

This last patient was a 1 week contact lens followup. She said she was doing really well with her contacts, but on the 4th day after she put them in, she suddenly "couldnt see a god damn thing". I knew immediately what the problem was...and when I told her, she said "no way!". Turned out I was right. This happens at least once or twice a month...even with experienced contact lens wearers.

What happened?

Inside out, or in the wrong eye.

[wizer]

Inside out, or in the wrong eye.

Score! They were in the wrong eyes.

Inside out is not really a good answer because:

If a contact lens is inside out, usually the vision is fair to good, not at the level of "can't see a god damn thing"...and often times they don't feel comfortable because the edges of the lens are flared upwards and interact with the upper and lower lids, and move excessively.

[GoodWitch]

Score! They were in the wrong eyes.

Inside out is not really a good answer because:

If a contact lens is inside out, usually the vision is fair to good, not at the level of "can't see a god damn thing"...and often times they don't feel comfortable because the edges of the lens are flared upwards and interact with the upper and lower lids, and move excessively.

Yeah but I did it myself LOL  I wore old-fashioned hard contacts from 1970 to about 1973 or 74, then I had extended wear soft ones, which I wore for 2 weeks at a stretch, until 1994 when I had the surgery I told you about previously.

So I've probably made just about every contact lens mistake there is! Once I thought I lost one, and it was in my eye all along, it had just moved off the iris. LOL

I miss them tremendously - I absolutely hate wearing glasses. The restricted visual field makes me crazy.

[wizer]

it was in my eye all along, it had just moved off the iris.

Cornea. It moved off the cornea, not the iris...LOL. We're even.

 

[GoodWitch]

Cornea. It moved off the cornea, not the iris...LOL. We're even.

 

Wait - isn't the iris the colored part of the eye? The contact lens moved off there onto the white part. Which is which? I forget.

I'm trying to learn equine anatomy now and I can't memorize the parts of the hoof either LOL  I'm going senile.

[wizer]

Wait - isn't the iris the colored part of the eye? The contact lens moved off there onto the white part. Which is which? I forget.

I'm trying to learn equine anatomy now and I can't memorize the parts of the hoof either LOL  I'm going senile.

The iris IS the colored part of the eye, and it is visible even though it is INSIDE the eye because in front of it is the clear cornea, where the contact lens is located when properly fitted. Adjacent to the cornea is the schlera, or the "white of the eye", which is where your lost contact lens ended up.

[GoodWitch]

The iris IS the colored part of the eye, and it is visible even though it is INSIDE the eye because in front of it is the clear cornea, where the contact lens is located when properly fitted. Adjacent to the cornea is the schlera, or the "white of the eye", which is where your lost contact lens ended up.

Oh OK. I always referred to the white part as the cornea. I don't know why!

[wizer]

[wizer]

When taking a visual acuity on a patient using their current glasses, sometimes a patient will be very blurred when looking at the distance chart about 15 feet away. This happens for a few reason, one being none other than stupidity on the part of the patient.

Sometimes a patient wearing bifocals will have their chin tilted up, and are viewing the distant chart through the bottom (reading portion) of the glasses.  I will say to them, "You are looking through the reading part of your glasses, and the chart is distance". At which point they will drop their chin and say "oh, that's much better!". You would think a patient who wears bifocals all the time would know to view the DISTANCE chart with the DISTANCE part of their eyeglasses.

[wizer]

Seems like I am getting a lot of patients lately who do this:

I tell them that I will be showing them two lenses...and they need to tell me which is clearer, "one or two".

I flip the lenses, "lens one, lens two". They answer "that's good". I will say, "Ok, it's good but it doesn't tell me which is better. I need you to answer with one or two". Patient: "Ok". Me: "lens one, lens two". Patient: "This is blurry". Me: "you stupid idiot, what part of 'answer with one or two' do you not get?

[wizer]

This old fellow tells me that he doesn't like to wear his distance glasses because he sees better without them, and he always has, "since the day he got them" from me, two years ago. But he "puts them on to drive because his license says he has to". So I figure, ok, either the glasses were made wrong (it happens), or his vision changed and he says it was since he got them but it was really at a later date.

I examine his eyes, and the prescription is pretty much the same as what I found 2 years ago. So now it seems like the glasses were made wrong. I read the lenses and I find them to be a totally different Rx then what he requires. I check the eyeglass order which is kept on the computer, from the prior visit, and the frame isn't even the same as the one he ordered. Different frame, different lenses...upon examining the frame more closely its determined to be a woman's frame.

I look up the wife's Rx on a hunch, and long story short, they're her glasses. Ok, so then what glasses are SHE wearing? She says "oh they're in the car, I never wear them". She goes and gets them, and there in the case are a brand new pair of never worn glasses. I hand them to the guy, he puts them on and says "These are great!".