Doctor DanB : Hello and thanks for your question. Why was the test done? Was it something they saw on exam that prompted the testing or was it a complaint that she didn't see well at night?
Customer: Neither. He was trying to figure out why her vision is so bad at the age of 6. He did a regular eye exam, said optic nerve looked fine and scheduled for the tests. The tests were done this morning and that's what I was told. I feel like I'm running in circles with no real answers.
Doctor DanB : Was her vision correctable to 20/20 in those glasses?
Customer: No. Never has been. More like 20/60
Doctor DanB : I can certainly understand your frustrations. As a parent myself, I would be frustrated if that was my only answer. Without really knowing the results, it sounds like they suspect that she has a dystrophy of the rod photoreceptors, the ones that enable night and peripheral vision (cones are responsible for day, central, color vision). My suspicion for why they decided they wanted her to come back and repeat it in a year was that, perhaps, the test results were ambiguous, meaning they weren't definitively positive or negative. They way you worded their reaction to the test makes me think that they found some abnormalities, but they weren't specific enough to suggest a certain diagnosis. I wish we didn't have test results like that in medicine, but unfortunately, that is all too often the case. Medical problems, even in the eyes, are usually not black and white and can often times be very gray.
Customer: Sorry I had the rod/cone mixed up. So these things change? So the test results could be different in a year from what they were today?
Doctor DanB : Yes, they certainly can be. As a disease like this worsens, the results can be more definitive and the clinical picture more consistent with a particular subset or type of disease. I would, however, not hesitate to recommend a second opinion. I don't think you can ever really go wrong with a second opinion. At the very least you have confirmation of what the first doctor told you (and maybe even a doctor who is a better communicator) or there maybe something uncovered that wasn't previously. Just something to consider...
Customer: Ahhh... This is going to drive me crazy. My child has other issues besides her vision being bad. He also mentioned more movement in her eye than before during the regular vision check. Is this good or bad?
Doctor DanB : By movement in the eye do you think he was referring to the eye spontaneously quivering or oscillating (back and forth)? The clinical term that he may have used may be 'nystagmus'.
Customer: He didn't say. He just said there was "more movement"
Doctor DanB : Okay, no problem. I can imagine this all must be quite overwhelming. My suspicion is that he is referring to the eyes involuntarily quivering or shaking back and forth, called nystagmus. Simply put, this is usually the brain's response to sub-par vision as the brain is trying to "find" an area of fixation that provides better vision. This is commonly seen in eye diseases where the vision is substandard or is progressively worsening.
Customer: Is it possible that my child could eventually lose her vision all together? I know you can't give me a definite but I just need a guess.
Doctor DanB : While my answer is couched in a healthy dose of speculation (without any certainty as to what's going on), if this is a retinal photoreceptor dystrophy (as it sounds), there is a possibility that she loses more vision until she is legally blind, yes. I sure don't intend to scare you or bring doom and gloom to you, but this is just my honest attempt to be straight forward with you, as I would want any doctor to be with me and my child. I'm sorry. I must step away from my computer for about 5-7 minutes. I promise I will be right back to continue our conversation and to address your remaining concerns / qusestions. Please bear with me. If, however, you are satisfied with our discussion up to this point and have no further questions...Your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied. My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!
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Doctor DanB : I'm back. Sorry for the delay. Do you have further questions about this?
Customer: No I don't think so. Thank you so much. I will be able to view this question and answers once I close it and rate it correct?
Doctor DanB : Mmmm... Sometimes I think it's kind of difficult to see the answers after the question is rated. I would suggest looking for the 'Share' link somewhere on your screen; if you hover your cursor over it you'll see options to email, print, or share the information. Alternatively, you could just select the text in the conversation with your mouse, copy and paste into a Word document. Make sense?
Doctor DanB : Alternatively, after you rate, I will have the ability to send you a follow-up message to see how your daughter's doing and I think this will allow you to access the original conversation.