Due to COVID restrictions, our staff is working split shifts. When I arrived to work one Monday afternoon, a staff member informed me that a long-term patient called to ask me to see his 101 year-old aunt, who is also a patient. She had been seeing a large black spot in front of her left eye for a few days.
He was directed by our staff to go to the nearest hospital where there is an ophthalmologist on call. We are in a rural area and do not have an ophthalmology department in our local hospital. He was upset as his aunt lives in a nursing home and they preferred she did not go to the hospital. Also, he did not feel that the patient was well enough to travel to this hospital and wait to be seen for an undetermined amount of time. He clearly stated that he would not take her to the hospital. Her physician was also away for the next three days. I made the decision to see this patient knowing that her primary care physician would not be able to examine, diagnose and treat for this type of symptom.
She was not feeling well on Tuesday, but she came to her appointment anyway. She said to me that her vision was important to her. “I don’t want to go blind”. Keeping the mask on throughout her examination was difficult for her. Even, walking down the hallway to my exam chair was difficult for her. It made me wonder how she could have dealt with a hospital ER.
At her previous yearly examination in 2019, this patient’s vision was excellent but was now diagnosed with a large choroidal neovascular membrane caused by wet macular degeneration. I contacted our local ophthalmologist and made arrangements for her to be seen for treatment. I explained the difficult situation with her fragile health, and they assured me that they would do their best to avoid any wait time in their office.
I can’t help but think back to the response that we got from the government during COVID that optometrists were not essential first line healthcare professionals. I honestly do not believe that this extremely vulnerable lady would have been able to access care any other way. Her nephew made it clear to us that the other alternatives were not an option for them. This patient was seen immediately in our office when she arrived and her visit at the ophthalmologist’s will be efficiently managed because they already have a diagnosis and are aware of her general health status.
Situations like this one happen every week in our practice. This patient, as well as all the others just like her, deserve the best possible care. This involves getting diagnosed and treated effectively. And it also involves looking at the bigger picture and participating in helping our elderly population have a better quality of life.