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Contact Lens Spectrum

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Patients Tell It Like It Is...Usually

Contact Lens Spectrum September 1, 1997

Patients Tell It Like It Is ... Usually

BY JOSEPH T. BARR, O.D., M.S., EDITOR
SEPT. 1997

A wise, highly experienced corneal surgeon once said, "Never place too much or too little credence in your patients' comments." We were discussing a patient's complaints of poor vision (measured at 20/20) and severe pain (not just discomfort) with a well-fitted RGP lens on an eye with an intact cornea, normal lid function, clear media and a good retina. It turns out that this patient has keratoconus and even with a well-fitted lens, he may have multiple images and poor low contrast visual acuity, and he has never been comfortable with a lens on his left eye.

Welcome to the age of people -- especially baby boomers and their offspring -- expecting perfection and efficiency. Many have very little loyalty, especially to a health care provider. They're convenience oriented, and price may be no object. Time is very important to them, and they'll readily tell you they'd rather be somewhere else making money or enjoying themselves than sitting in your chair.

Just a few days ago, we refitted a pharmaceutical salesman who previously wore spherical disposable lenses OU with a toric soft lens OS to improve his vision and, he hoped, his golf game. He returned to our office, said he didn't have time for this, that the new left lens was painful and he wanted his old lens for his left eye so he could leave quickly for the airport. We rarely have comfort problems with this type of toric lens, but I had to believe him on the spot and get him back in his old lens and off to the airport. We could have said, "Let's just look at that lens on your eye now," but he was having none of that. His lens caused "pain." Sure, it may have had a split in it, but he had tried another lens in the same package and got the same "pain." So off with a box of his spherical lenses he went, saying, "next time I should schedule late in the day on my way home from work." I agree. And I know we'd better be ready with a new lens type, and it had better work. It may be our last chance.

Sometimes it may sound like patients are whining when their symptoms far exceed the signs, but we must listen, find the problem and solve it promptly. You may think a visit went well, but if the patient doesn't, it makes little difference what you measure or see with a slit lamp. Believe that his vision is poor if he takes the time to return to your office. You and your staff must consider every symptom serious until proven otherwise. Empower your staff to deal with these issues whenever they can safely do so.

In this day of better products and high expectations in a fast-paced society, taking care of what you think are the little things and taking care of them fast, can be the difference between a good day and a bad day and between a successful practice and one that struggles. CLS

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