Eyeworld

EW NEWS & OPINION March 2017 37 Editors' note: Dr. Wilhelm has no financial interests related to his comments. however in older patients, he will want to exclude temporal arteritis. Another symptom that may make ophthalmologists think "brain tumor" is papillitis, or papilledema, Dr. Wilhelm noted. This results from increased intracranial pressure. Op- tic discs that look like papilledema do not always have to be a red flag. Drusen of the optic disc are very common and run in families. Dr. Wilhelm said that unfortunately, eye doctors will not always remember these sobering facts when diagnos- ing papillitis in young patients. "This is a mistake that is made frequently, and it's what many consider to be a true professional blunder. Most 'professional blun- ders' are not iatrogenic in nature. They are not made in the OR or as a wrongly administered treatment— they are the ones that occur from saying the wrong thing to a patient and creating undue anxiety," Dr. Wilhelm said. Look for signs of stroke Signs of stroke can be elusive but need to be identified in a timely manner, as the chances of having a second stroke within 1 or 2 days af- ter the first are 10% to 20% and can be much more damaging, according to Dr. Wilhelm. One case he dis- cussed involved a middle-aged man with temporary visual disturbances over a period of 2 years, culminating in the sudden onset of permanently reduced vision on one side along with a frontal headache. The clue was in the visual field, where Dr. Wilhelm noticed small, seemingly insignificant spots in both fields at the same location. Upon further testing, these were determined to have been indicative of stroke. He noted that sometimes vague, osten- sibly inconsequential signs were the key to diagnosis. "In my opinion, we see this sort of thing more and more these days, that eye doctors are at a loss to diagnose neurology-related signs and symptoms and prefer refer- ring patients to their colleagues in neurology than hashing it out on their own. Neuro-ophthalmologic knowledge is not what it should be and consequently too many mis- takes are being made. We need to have sound and solid basic knowl- edge in neuro-ophthalmology. If we can remember some of the points from this discussion, we'd make less professional mistakes and serve our patients better," Dr. Wilhelm said. EW Does "Made in America" make a difference? Industry-leading Reliance chairs, stools, exam equipment and accessories are enduring proof that it does. Every Reliance product is manufactured in the heartland with parts and materials from more than 150 suppliers across the U.S. - which is why you're able to depend on us for unrivaled design, durability, and longevity. Find out more about why the strongest practices around the world use the strongest products, made right here in America. Visit BuiltToSupport.com. 800-735-0357 © 2017 Haag-Streit USA. All Rights BUILT TO SUPPORT YOUR PATIENTS, YOUR PRACTICE & AN ENTIRE COUNTRY. With strength, style, and long-lasting, American-made craftsmanship. Visit us at ASCRS Booth #2013 Contact information Wilhelm: helmut.wilhelm@med.uni-tuebin- gen.de

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