Hospital Appointment

Hi All,

Well, I finally got my appointment through for the hospital appointment,
for what I can only pesume a full range of tests for this "fixation
disparity" that has been noticed.

If you remember, they've tried the red line through a white dot, where I
needed like 8 Prism for the red line to get anywhere near the dot, but
even then, the red line kept bouncing around... they'd add a prism, then
things would bounce back to "normal".

Then there was the OXO test, where both green lines were in line with
the X, but neither line was in line with each other.

Only that needed a couple of prisms, and still wasn't right.

It all came about because in October, after returning to work after a
three week absence, anything written on paper, was looking kind of fuzzy
with almost an orange hue around the outside, where as the new LCD
monitor we had was absolutely crystal clear. Things also didn't seem
flat, and there was a sense, of distorted sort of goldfish bowl type
vision (but Im probably making that one up), but things sort of appeared
"magnified".

That lasted for a few weeks then disappeared, even though there was a
fixation disparity on eye tests. I havent noticed anything similar in my
field of vision, except it does seem to be coming back over the past few
days.... just minor in my distant vision (5m+).

Well, I've got my appointment on Monday for, god knows what, some kind
of eye test... maybe more, then seeing the consultant on Friday.

What should I be asking. If anything?

Cheers
Simon

 

Simon, the first thing you need to do is relax. These tests for
fixation disparity and eye alignment are going to help the optometrist
or ophthalmologist in their assessment.. There is no "right" answer,
only "your" answer. There is an anxiety component to most fixation
problems, and if you are "trying" to give an answer you will ruin the
validity of the tests. In this case, the less you know might be
better, because you won't be trying to see what is expected. Just do
the tests and listen to the results as they are explained to you.
Being naive can be a good thing on tests that are that sensitive to
bias.

 

???

I am relaxed, and ready and accepting to get some useful results or
information that might make things better. Im not trying to fix the
results just say what I say, which I have done on my previous optician
eye tests.

Im just curious if there is anything I can ask, or say, which might help
the opthalmologist more, or might explain something to me or something...

I think I know what you mean, but you can you not "try" to give an
answer on the prism tests... I merely state what I see... I don't know
where you got anxiety issues from?

Thanks
Simon

 

Having been through scads of these tests myself, Simon, I think I
understood what doctor_my_eye meant.

Generally, I believe in doing a significant amount of homework prior to
eye exams, especially if you're moving into unfamiliar territory (eg,
new problem). With information, what the doctor tells you may have a
ring of familiarity to it, facilitating your understanding and
increasing the likelihood that you'll remember what you were told 15
minutes after you leave his office.

In this kind of testing, though, I'd probably sit quietly and
cooperatively /during/ all of the tests, then listen extremely closely
to the doctor's conclusions /after/ the testing.

Many of these tests mean nearly nothing until the rest of the tests are
performed. Asking questions too early can throw both the doc and the
patient off a little as differential diagnoses rely on /several/ tests
painting a picture for a doctor that can then be interpreted.

Once the doc had the whole picture, it's highly likely that he/she is
going to give you a verbal summary of what was done, what was found,
and what the options are. THIS, IMO, is where you sit up, pay close
attention, and put up your proverbial hand any time something is said
that you don't understand.

I think it's difficult to arm you with preparatory questions for a
visit like this. If we were all listening to the the doc's 'final
narrative,' /that's/ when the questions start coming. Just make sure
you understand that narrative, and any recommendations coming out of
it, word for word.

Good luck!

 

Well that makes perfect sense, and my apologies to doctor_my_eye for not
understanding. No, that's probably what I'll do as well. Wait for the
consultant appointment at the end of the week, hear, and then give my
questions.

But I was thinking if Im asked to describe something, if there's a good
way of explaining things, or, when the time comes, at the end of the
week, offering my own personal experience and observations in the best
possible light to be taken seriously and not just dismissed.

And at that point, if I think there's something relevent to add, should
I add it?

understanding the narrative, and remembering the narrative is something
different. I mean, I remember one of my last appointments, I was told to
wash my eye with baby shampoo. I didn't understand he only meant to wash
the eyelid, and the outside at that!

Thanks
Simon

 

If you want to relay additional information to the doctor that you
think will help him understand what you're experiencing, then I'd
suggest doing that /before/ all of the testing starts. I remember
talking with a pilot who was at my strabismus ophthalmologist's office.
We both remarked that -- while driving -- left turns were difficult.
Each of us was having trouble with alignment when looking far to either
side. In a left turn, you look left, then right, then left, then
right.

Anything that helps to explain *the problem*, under what circumstances
you notice the problem, and anything that helps to *prevent or relieve*
the problem is likely to be helpful (ex: "I notice that I seem to see
double when I'm looking upward, like standing at an airport reading the
flight schedules on the board above me. It gets better immediately if
I cover one eye").

The thing about the presentation of this kind of information is: you
should think it through first, so that--when you do present it--you're
clear, concise, and on point. If you start wandering off topic, or are
unclear, you're unlikely to hold the doc's attention, despite his/her
best intentions.

Sure. Again, though: I'd present my info before the testing, to paint
a clearer picture of what I'm experiencing. If this isn't a first
visit to this doc, then just add anything *new* that you hadn't talked
of before. If it IS the first visit, then explain your symptoms as I
indicated above.

Also, after the testing and the 'narrative,' that's the time to sort of
"read it back to the doctor," to ensure that you understood correctly
(ex: "Let me see if I understand this: esotropia is an inward turn of
the eye. You think this can be causing the visual issues that I'm
experiencing. What does the "incomitant" part mean again??"

If the doctor hasn't given you his opinion of the cause that satisfies
the entire picture, don't be afraid to ask (ex: "Ok, I get how that
would cause me difficulty when I'm looking *down*, but what about the
whole 'left turn issue?'")

If you can listen and write at the same time, don't be afraid to take
notes. If you have a friend who's fairly scientifically-inclined and
would be willing to take notes for you, bring that person. If you have
a tape recorder, you can ask the doctor if they would mind (some will)
if you tape the meeting so that you remember and understand everything
that they tell you. If none of that is practical, then the repetition
back will help you clarify and retain. Also, get a copy of the chart
once it's finished. You'll have the doctor's notes about your
situation.

That--to me--is something that everybody should do anyway: keep a copy
of your own chart. When I walked into the Optometry college with my
volume three weeks ago, they were giddy. They get a whole lot more out
of the findings of their colleagues then they're likely to by listening
to my ramblings....

You'll do fine, Simon. I hope it's something simple and easily managed.