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"Visual problems completely dismissed twice"

About: Western Infirmary/Gartnavel General / Ophthalmology

(as a service user),

Two years ago I was referred to Gartnavel by my optometrist urgently (the same day! THAT urgently) for suspected corneal dystrophy in my right eye because I had been suffering recurring erosions for several years and the latest incident involved a detatched piece of cornea. The doctor who examined me dismissed it as "just an erosion" with "no underlying condition" and sent me away with some ointment. At the time, my optician was not impressed with the outcome and demanded they see me again and that a consultant examine me. When I went back three days later the consultant discovered I did in fact have epilthelial dystrophy in my right eye and that the condition of it was so bad that most of the cornea was comprised of scar tissue. Apparently it was severe enough that he called in a further three consultants just to look at my eye - not for a second opinion, but because it was unlike anything he had seen. The problem have been apparent to even the most passably-competent examiner and yet I was resoundly dismissed and made to feel that I was making a fuss of nothing.

Fast forward to now. I have always had extremely good vision (the dystophy in my right eye doesn't cause visual problems, and I require no corrective equipment. I have excellent sight both near and far, excellent colour acquity, and no astigmatism or glaucoma etc. My eyes are, per my exam within the last 6 months, "absolutely perfect"). A week ago I woke up with sudden onset blurred vision in my left eye which got worse over the period of several days.

Again my optician arranged an urgent examination at Gartnavel - sudden vision loss not being anything to be delaying on. Despite my vision being blurry, I can still read. Letters are shapes, they do not become completely illegible with a bit of blur. During my preliminary eye examination I sailed through on the right eye and, though I got to the same point with the left eye, I had to take several attempts at it. I was not entirely certain of most of the answers (responding such as "uhhhhhhhhhhhhhhhhhhh...V? I think? Maybe?), and was squinting - it was *obviously* a struggle. My eyes were marked "equally good".

I was repeatedly told throughout the afternoon that I had "good vision" in both my eyes - so blurriness constitutes "good vision" if you can still discern shapes? If you know what a Z looks like with a blur filter on it? I pointed out again and again that I am perfectly capable of reading even very small writing with considerable blur on it and that doing so doesn't make it not blurry,  but my vision was REPEATEDLY dismissed as "completely fine". I felt like I had no way to "prove" that my vision was "actually" blurry, and also completely baffled - do they mean that none of them are capable of reading even a single word if it is a little out of focus? I think perhaps it is not me who requires an eye test. Next they will be telling me that being able to read upside down is a rare skill.

I was administered a test to read coloured numbers inside of coloured circles - the colourblindness test. My good (right) eye was tested first. The exact same images in the same order were then used for the left eye. When you already know what something says or know what to expect, your brain will easily fill in the gaps for you so how could I possibly give an accurate response with the left eye? If you insist on using the same images in the same order for both then at LEAST start with the eye that is of concern.

My blurred vision was not even slightly accepted as a legitimate concern that really existed until I was administered eyedrops to enlarge the pupil - this makes your vision blurry. At that point my right eye was in about the same state as my left had been previously. Only then, when I was able to demonstrate that I still had the "same" level of vision - because they couldn't deny my vision was blurry - did the doctor acknowledge that I was telling the truth about the condition of my left eye and that perhaps it actually isn't "just as good as the right one" and perhaps I don't have "good vision" so much as semi-decent pattern recognition. Although I was informed that my blurry vision is still somewhat better than their glasses which is a bit concerning... for the doctor.

After doing various tests, nothing could be found to be physically wrong with the eye (although as pointed out previously - massive corneal dystrophy had previously gone completely unnoticed in the same department so you will understand my lack of faith in that particular outcome). Told again that "my vision is fine" as a result after I had only JUST gotten someone to acknowledge that, yes, possibly I had blurry vision. But now we're back to "actually you don't and everything is fine and your eyes are really good". No particular concern at any point was given to the fact I dropped several vision points quite literally overnight. Mostly because nobody believes I have.

I have no other symptoms in my left eye of any corneal dystrophy, and there was no evidence of dystophy in any of the examinations, yet I was sent away with ointment or drops "for dystrophy" - the SAME ointment and drops I already have for when my right eye is experiencing problems, and the SAME ointment and drops I had already been using in the left eye with absolutely no positive change.The doctor acknowledged that the only thing that hadn't been ruled out is a physical brain issue but that we should "hope it just goes away" in the next 4-6 weeks. No investigation is to be done - so we are to ignore a potentially very serious issue in my brain for 6 weeks in the "hope" my vision returns to normal? And what then? We don't care about the casue - which may still be neurological? Which may still lead to permanent sight loss? Potential (and if the tests are to be believed as accurate this time around, not only potential but highly LIKELY) neurological issues are not something to be ignored for several weeks "just in case".Sudden onset visual impairment is considered a serious medial issue by everyone - seemingly except Gartnavel eye department.

Since the events above several months ago, I would like to make some additions:

1) My GP tried to get the department to see me again after the condition worsened and the triage nurse all but laughed him off of the phone because "my eyes are fine" and told him I'd have to wait for the 4-6 week follow-up.

2) I never actually RECEIVED the 4-6 week follow-up, so I have not been seen since.

3) I later diagnosed myself with hypermobile ehlers-danlos syndrome which causes such "impossible" eye problems as I was experiencing due to malfunctioning collagen in the eye itself, something an eye specialist would be aware of you would think, and this has now been ratified by the relevant doctors and is on my file.

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Responses

Response from Nicole McInally, Patient Experience and Public Involvement Project Manager, PEPI, NHS Greater Glasgow and Clyde 3 years ago
Nicole McInally
Patient Experience and Public Involvement Project Manager, PEPI,
NHS Greater Glasgow and Clyde
Submitted on 24/08/2020 at 16:12
Published on Care Opinion at 16:12


picture of Nicole McInally

Dear Happy C

Thank you for taking the time to share your experience. I am so sorry to read that it was not a more positive one. It sounds like you have had a difficult time which we would like to look into. Should you wish to provide us with your personal details (name and date of birth), can you please email us at PatientExperience@ggc.scot.nhs.uk so that we can look into this for you.

Thank you

Nicole

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