2009.03.03 02:31:28

John McDaniel

#1…Is This Thing Going to Blow Air into My Eye?

• After handing the patient the cover paddle and asking them to cover their left eye they asked (very suspiciously) “will this puff air in my eye?”
• After performing confrontations on a very tense patient they noted “I was just waiting for the air that time”
• When occluding an eye in mid refraction the patient jumped back and scolded me for not warning him that the puff of air test was coming.  He didn’t believe me when I told him there was no puff and that it was more likely that his lashes were touched by the occluding mechanism.
• While attempting stereopsis testing a patient refused to put on the polarizing glasses for fear that they might blow air into his eye

I’ve left out any instances that might have even a remote sense of logic – such as pupil testing with a transilluminator or slit lamp biomicroscopy or any machine like an auto refractor.  At least those instances make some sense when people over react to them.

As a result of the ubiquitous nature of this concern I’ve started to rework my natural script when dealing with these inquiries.  Now I pick from a variety of responses, such as:

• “Air?  You wish it was just air!”
• “No, this takes air out of your eye; please don’t ask me how it does that”
• “This machine is new and uses fire instead of air – tell me if you like it better”
• “The air puff comes right after the needle prick so don’t worry about that air just yet”
• “We use electrical shock to the eye now a days, hurts more but scares you less”
• “The machine measures pressure better when cow flatulence is used instead of regular old air”

OK, I confess, even I don’t have the stones to say this to patients but I am thinking it.

After creating a top 10 list I am now in search of the ultimate patient; one patient that embodies all of the top 10 and demonstrates them all during a single encounter.  That dream patient that licks the cover paddle, gives dry eye lectures, takes 34 minutes on the phone to schedule the appointment, cries like a schoolgirl after the drops are instilled, giggles incessantly at the acuity chart, exclaims “that light is so bright, do you really have to do this,” screams “is that going to puff air into my eye” as I pump hand sanitizer into my hand, sits on the doctors stool instead of the patient chair, and that pages me later that same night wondering if itchy teeth constitutes an ocular emergency.

Hey, I can dream, can’t I?

Le Meas,

John McDaniel, OD, MLHR
President/Founder
Waugoo Consulting Group, LLC
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