A Patient’s Viewpoint of Cataract and Retinal Detachment Surgeries

Abstract

Aims: The purpose of this paper is to (1) describe the changing details of a complex medical case study from the patient’s view allowing the reader to continually evaluate complications resulting from cataract and retinal detachment surgeries, (2) explain good and bad aspects of communications between patients, optometrists, ophthalmologists and systems engineers and (3) show a patient’s view of a detaching retina. Methodology: This paper was written from the patient’s point of view of the interactions between the patient, the optometrist and the ophthalmologists during a dozen eye surgeries for cataracts and retinal detachments. It was excerpted from the patient’s notes (including test results, charts and images), surgical reports, letters to the doctors and their referral reports. This paper was written in the first person singular and in chronological order. This should help the reader to see changes in the interactions of the symptoms and treatments from ocular surgeries in a multifaceted medical example. Results: This paper has documented malplacement of an intraocular lens, ignoring patient’s complaints of pain, lack of explanation of what the subject should expect after retinal detachment surgery (such as strabismus, diplopia, pain, wrinkled retina, and dynamic visual changes due to gas bubble absorption), lack of explanation for the subject’s potential visual acuity defects and color deficiencies, poor communication between patient care specialists about these defects, lack of knowledge by technicians using ophthalmological instruments, lack of documented processes for using these instruments (which means different technicians used the instruments differently), lack of proper medical care due to physician overload (i.e. scheduling more than 60 patients per day per physician), and ignoring the patient’s complaints of pain. While reading this paper, the reader should accept or challenge each of these assertions. Conclusions: Pain is hard to diagnose, measure, quantify and treat, making it frustrating for both the patient and the physician: in this case, there were many causes of the pain, which caused confusion. For the last six years, this patient complained about ten specific symptoms, which were treated individually: treating this case as a system of interacting problems led to a better understanding and resolution.