It’s strange to me how health care is sometimes organized in boxes.
The teeth are part of the body and infections in the mouth can cause profound medical problems. Yet, dental insurance is a separate policy from health insurance. Medicare only rarely covers dental work.
There’s a similar situation for eye care. Optometrists are medical professionals who deal with vision correction, as opposed to ophthalmologists who are physicians dealing with medical conditions of the eye. Most optometry care is covered by a separate vision insurance policy, as opposed to health insurance, which only covers medical care of the eyes.
Perhaps because of the different insurance systems, some emergency room and hospital personnel drop the ball when patients seek urgent or emergency care for medical problems dealing with the eyes.
Anyone who’s had an eye exam will probably remember having a pressure check in both eyes. This is part of the preventative care to look for glaucoma, also called ocular hypertension or high eye pressure. When glaucoma is untreated, it can damage the optic nerve and cause blindness.
Evaluating the causes of glaucoma is really the province of the medical specialty of ophthalmology. Diagnosis and treatment in an emergency situation, though, can be the responsibility of ER physicians, nurse practitioners and physician assistants.
Most eye professionals consider an eye pressure of greater than 22 mm Hg to be abnormal. It’s typically measured using a device called a tonometer or tonopen. When ER personnel are unfamiliar with the device or how to measure eye pressure, it can create a danger to patients, including causing blindness.
That’s what happened to a man who went to a hospital emergency room complaining of eye pain and visual problems in both eyes. The emergency physician didn’t measure the patient’s eye (intra-ocular) pressure, but instead chose to discharge him with pain medications and instructions to see an ophthalmologist if needed.
By the next day, the man’s pain and visual disturbance was worse. He went to a different emergency room, where an ER physician measured his intra-ocular pressure using a tonopen. He was quickly diagnosed with high eye pressure, specifically acute angle-closure glaucoma.
Many cases of glaucoma develop slowly over time. They are globally described as chronic glaucoma.
Acute angle-closure glaucoma, though, is a serious medical condition that comes on quickly, caused by a sudden raise of the fluid pressure inside the eyes. Patients describe it as causing severe eye pain associated with redness or blurry vision. For some patients, it also causes nausea.
The standard of care requires immediate treatment with medications to lower the intra-ocular eye pressure. This medication can come in the form of beta-blocker eye drops and steroids, or an injection.
When a patient is seen in the ER with complaints of severe eye pain and visual disturbance, the standard of care requires consideration of the differential diagnosis of acute angle-closure glaucoma. If the diagnosis is confirmed by measuring eye pressure, quick medical treatment needs to be administered by the ER personnel or in immediate consultation with an ophthalmologist. A delay can leave the patient with permanent blindness.
If you’ve been seriously injured because of poor eye or medical care in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for free consultation about your potential case.
