as Guardian Angels
truly occupy a special place in health care.
optometrists can forget sometimes how blessed we are to be in this profession. We
have unique skills that we use daily to help people in a tangible way. I feel that
God called me into optometry to help improve people's lives, but I never thought
that I would use my profession to help save someone's life.
Life throws a curve ball
D.H. was a healthy,
vibrant 52-year-old woman when she came in for her routine eye exam. She took good
care of herself: a healthy diet, a daily multivitamin, and she worked out at a
Curves gym three times a week. She also had her blood glucose checked every three
months because her father was a diabetic. Her only visual complaints were that it
was getting harder to focus on her sewing and her glasses were scratched.
exam was proceeding as normal just a slight bifocal change and mild dry eye.
I explained the importance of routine dilation, which she readily agreed to because
of her father's diabetic retinopathy. What I saw when I looked in her eyes surprised
us both. She had multiple dot and blot hemorrhages in the macula and periphery of
both eyes. Some of the hemorrhages had white centers indicative of Roth Spots.
We discussed the
possible etiologies, none of which were reassuring, and I obtained an urgent retinal
consult. Within 48 hours she was in an appointment with the ophthalmologist, who
ordered STAT blood work including a random blood glucose,
with differential and platlets because of the Roth Spots. Her white blood cell count
came back in excess of 230,000 cells/mcL (with normal being around 10,000 cells/mcL).
She saw an oncologist in Indianapolis the next morning. Her diagnosis: acute mylogenous
Two weeks later,
after a six-day stay at the cancer center going through leukophoresis and starting
on chemotherapy, D.H. came back to tell me "Thank you" for saving her life. The
oncologist told her that if she had not had an eye exam when she did, her leukemia
would not have been discovered as early as it was, and it would have certainly
been fatal. With her white cell count as high as it was, she could have had a fatal
stroke at any time. However, she now has a 98% chance of survival. She also said
her oncologist was impressed that an optometrist found the hemorrhages that ended
up saving her life. Needless to say, D.H. is now a firm believer in "routine" dilation!
Don't take it for granted
As I was blinking
back the tears at her "thank you," I found myself saying "thank you" to God for
our profession and the unique opportunity we really have to help our patients. Even
the opportunity, occasionally, to help save a life.
recently received a follow-up letter on my patient. Her retinal hemorrhages have
resolved and she is still 20/20 in each eye. She'll be on chemotherapy for the rest
of her life, but her prognosis is good.
DO YOU HAVE
A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH
RENé LUTHE, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC
MANAGEMENT, AT (215) 643-8132 OR LUTHER@BOUCHER1.COM.
OM OFFERS A MODEST HONORARIUM FOR PUBLISHED SUBMISSIONS.
Optometric Management, Issue: June 2005