What questions should I ask?

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Salmon Egg - 12 Feb 2008 23:24 GMT

I am going to see an ophthalmologist tomorrow. I have some retinal
problems for which I do not expect further treatment to be useful. I am
using brimonidine and Travatan. I have had lens implants in each eye
because of cataracts. Two other problems are:

1. I get light scattering that greatly reduces contrast. If I keep
off-axis sun from striking the anterior of my eye, the improvement is
obvious.

2. I have watery eyes. The variable tear film distorts what I see.

Is it unreasonable to expect an ophthalmologist to help with these
problems? What can I do or say to be taken seriously?

There is another phenomenon that I noticed that cries out for an
explanation. I see a transient colored (rainbow) patch of light in the
lower left of my right eye's (best eye) field. At first I thought that
it was coming from dispersion arising from the boundary between the main
bifocal lens and the add lens. So far, I have not been able to position
my head and eye in such a way as to get a steady state rainbow. Any
thoughts?

Bill

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Neil Brooks - 12 Feb 2008 23:33 GMT

> I am going to see an ophthalmologist tomorrow. I have some retinal
> problems for which I do not expect further treatment to be useful. I am
> using brimonidine and Travatan.

[snip]

> 2. I have watery eyes. The variable tear film distorts what I see.

Travatan or Travatan Z???

The former is preserved with BAK -- KNOWN to CAUSE dry eyes (a symptom
of which is/can be excessive tearing). The latter uses something else
that -- AFAIK -- does NOT have significant testing behind it to see
whether or not IT, too, causes dry eyes.

If it were me, I'd ask about a preservative-free anti-glaucoma drop.

Ditto your brimonidine. If it's preserved, I'd go preservative-free,
if possible. If it's NOT possible, I'd definitely get away from BAK
in any case. Bad stuff.

Best of luck.

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Salmon Egg - 13 Feb 2008 03:54 GMT

In article
<d36162c4-bd03-4f76-b994-eef33a1f1f52@e23g2000prf.googlegroups.com>,

[snip]

> > 2. I have watery eyes. The variable tear film distorts what I see.
>
[quoted text clipped - 10 lines]
> if possible. If it's NOT possible, I'd definitely get away from BAK
> in any case. Bad stuff.

Both of these medications do indeed contain BAK.

Bill

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spammer - 13 Feb 2008 00:06 GMT

I would also print out this thread to take to your doc so you don't
forget to ask these questions.

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Dan Abel - 13 Feb 2008 04:54 GMT

In article
<SalmonEgg-C8F9ED.15244712022008@newsclstr02.news.prodigy.com>,

> I am going to see an ophthalmologist tomorrow. I have some retinal
> problems for which I do not expect further treatment to be useful. I am
[quoted text clipped - 4 lines]
> off-axis sun from striking the anterior of my eye, the improvement is
> obvious.

I wear a hat outside, 99.9% of the time. If I'm taking out the garbage
or getting something from a vehicle, I might skip the hat. The brim
needs to be large enough to shield the eyes from light coming in from
the side.

> 2. I have watery eyes. The variable tear film distorts what I see.
>
> Is it unreasonable to expect an ophthalmologist to help with these
> problems? What can I do or say to be taken seriously?

Seems reasonable to ask for help. Either the doctor can help, refer you
somewhere or just say that it can't be fixed. If you present the
problems and listen to what the doctor has to say, then it is the
doctor's job to take you seriously.

Signature

Dan Abel
Petaluma, California USA
dabel@sonic.net

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Don W - 13 Feb 2008 18:14 GMT

> Seems reasonable to ask for help. Either the doctor can help, refer you
> somewhere or just say that it can't be fixed. If you present the
> problems and listen to what the doctor has to say, then it is the
> doctor's job to take you seriously.

So what happens if the doctor does not take the complaint "seriously"?

Don W.

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Neil Brooks - 13 Feb 2008 20:04 GMT

> > Seems reasonable to ask for help. Either the doctor can help, refer you
> > somewhere or just say that it can't be fixed. If you present the
> > problems and listen to what the doctor has to say, then it is the
> > doctor's job to take you seriously.
>
> So what happens if the doctor does not take the complaint "seriously"?

At the risk of stating the obvious, find another doctor.

This is a pretty fatal error, in my view. If you've done a little
homework, and your questions/concerns have even a HINT of legitimacy,
though, and potential behind them ... then I'm not sure why you'd work
with a doctor who didn't take the time to look into them.

For example (only): the BAK thing. If your doctor dismisses it,
doesn't know about it, or flat-out says it's untrue, you do a quick
bit of research (or e-mail me and I send it to you) that shows he's
clinically wrong .... if, that is, he uses randomized controlled
clinical tests to inform ANY of his medical decisions.

If he isn't interested in that ...... I dunno. I wouldn't see him (/
her) again.

It's not reasonable to expect your MD to listen to Otis Brown. It IS,
OTOH, reasonable to expect that they listen when YOU are using the
same sources (who, in turn, are using the same methods) that THEY are
using.

Dismissive docs get no love from me. Your eyes are watery? Blot them
with a Kleenex. Don't worry about it so much. Some eyes water.
Well, you ARE getting older, blah, blah, blah. These are /not/ made-
up responses. Ask me where I got them ;-)

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