MAR 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/276058

Contents of this Issue


Page 76 of 210

E W CATARACT 74 March 2014 by Richard Tipperman, MD Answering the question T here is a classic story of a young boy who one day at the dinner table asks his parents, both ophthalmolo- gists, "Where did I come from?" The parents look at each other a little chagrined, having i magined this "talk" would come a few years later rather than arriving so precipitously. Nonetheless, being caring and involved parents, they launch into a discussion of reproduction, fertilization, and embryogenesis. Their son looks at them, taking this all in, then after a few minutes responds, "No, I mean m y friend Johnny is from New Jersey; where am I from?" Miscommunications related to misunderstandings occur frequently, a nd in the setting of a physician/ patient relationship can at the very least cause confusion or in the worst cases impair patient care. If a patient asks his surgeon after surgery, "Should I resume my medicines?" the doctor may assume the patient is referring to his glaucoma meds since the patient is holding those bottles. T he doctor might respond "No," but in this case the patient was talking The art of advanced technology IOLs Richard Tipperman, MD about his warfarin and the doctor assumed the patient was talking a bout his glaucoma medicines. Making sure you respond to what a patient is requesting or ask- ing often involves physicians asking questions themselves. For example, how would you respond to a patient who says, "I want to be able to see up close after cataract surgery." Does "up close" mean reading vision, i ntermediate or computer vision, or 5 inches from the patient's face to thread a needle? Part of the requirement for answering this question involves getting more information from the patient, but another part of it in- volves educating the patient. "When you say close up what do you mean? Are you talking about reading vision? Computer vision? Very close work? Show me with your hands where you want to see." At this point it may become clear that the patient has very specific near vision needs that will make it much easier to make recom- mendations during surgery, or on occasion it will become clear that the patient has visual expectations that are either difficult to reach or unreasonable. It's not uncommon for patients to say, "I want to see perfectly at all distances." Usually when I hear this I smile and remark, "Although as eye surgeons we want to make all patients see the best they can, 'perfect' is not a word we like to use. This is still a surgical procedure that relies on man-made technol- ogy—it can make you better but not likely perfect." Personally, if patients want to be "perfect" or want a guarantee that they will never wear glasses again, I explain to them that I do not have a lens or operation that can guarantee this, and they would be better off foregoing surgery. Remember, the next time pa- tients ask you a question, before you go ahead and answer, make sure you understand what they are really ask- ing. EW Editors' note: Dr. Tipperman is affiliated with the Wills Eye Institute, Philadelphia. Contact information Tipperman: rtipperman@mindspring.com 64-75 Cataract_EW March 2014-DL2_Layout 1 3/6/14 3:10 PM Page 74

Articles in this issue

Links on this page

Archives of this issue

view archives of Eyeworld - MAR 2014