Openly talking to your eye doctor is critical to participating fully in your eye health, yet many patients shy away from discussing their concerns.
In a survey conducted in July 2017 by Allergan (which makes RESTASIS Multidose, an eye drop that treats chronic dry eye) and Kelton Global, a consulting firm, more than half of the 1,053 participants felt most comfortable talking about their health with a general practitioner, yet only 6 percent felt the same way about talking with their eye doctor.
What’s even more troubling than this low percentage is, even though most of the patients surveyed visited their eye doctor in the past five years, they reported having trouble raising concerns about common symptoms like change in vision, burning or stinging sensations, redness, or watering eyes while in the examining room. In fact, they often left their examination regretting not asking more questions.
Neda Shamie, M.D., an ophthalmologist specializing in corneal, cataract, and refractive surgery based in Los Angeles, is here to remind you that your eye doctor cannot provide comprehensive health care if he or she doesn’t know the discomforts you are experiencing.
During a conversation with Dr. Shamie, she shared with HealthCentral how patients can initiate conversations with their eye doctor and, in turn, take full ownership of their eye health. This can be done by taking a few simple steps toward preparedness. Here’s what she told us.
HealthCentral (HC): Why is a patient’s conversation with his or her eye doctor just as important as the physical examination?
Dr. Shamie: The art of medicine comes down to relationships. When you have that conversation, we as doctors are equipped with the right amount of information to use the right diagnostics so that we don't use your time inefficiently and we don't overuse diagnostic testing that would be unnecessary. It helps us hone in on the problem. It's those conversations that can also highlight emergent problems that can occur. Medicine cannot be medicine with just diagnostics. Otherwise, I'd be out of a job; a robot could do what I do. So, it really is important to use your doctor, create a relationship with your doctor, engage them in your health care, and create a long-lasting advocate for your health.
HC: Why aren’t patients having better dialogue with their eye doctor?
Dr. Shamie: A lot of it stems from misinformation, and some of it stems from denial. [Patient’s think] that if I don't have glaucoma, dry eye is not as bad as glaucoma, or if I don't have macular degeneration, dry eye is not worthy of attention. When, in fact, dry eye is far more common and can become a much bigger problem if it's not dealt with from the outset. It's not OK to have a sensation of your eyes; you really should not be aware of your eyes. Aging comes with a lot of changes, but please don't blame changes that should not be occurring on the process of aging. As eye doctors, it's our job to keep your eyes as healthy as possible. Just speak to us so that we're engaged in that problem.
HC: What steps can patients take to improve the way they communicate with their eye doctors?
Dr. Shamie: They can empower themselves with information. They can go to online resources to get the right information to understand if their concerns are concerns that they should bring up. They can take online health quizzes, such as a dry eye quiz. Often patients don't understand that the symptoms that they're experiencing — such as burning of their eyes, itching, irritation, tearing, their inability to tolerate their contact lenses —these are real concerns, and they're typically associated with a diagnosis of chronic dry eye disease.
Unless they're empowered with that information, come in with a mental log of those symptoms and possibly the results of their quiz, the doctor may not be able to start that conversation and offer them the right treatment.
HC: In addition to dry eye, what conditions are patients commonly presenting with that they are not recognizing and bringing to the attention of their doctor?
Dr. Shamie: Patients come in with not necessarily their concerns but rather a diagnosis or treatment they're expecting. They say, “doctor, I'm coming in to get cataract surgery,” or “I'm coming in because I want to have LASIK done.” It's not until the doctor asks, “why do you feel that way?” that it becomes clear that they're coming [in] because they may have decreased vision or they can't tolerate their contact lenses. Other issues with decreased vision as a result of glaucoma or macular degeneration are all potentially irreversible conditions if they are not dealt with early. If you can go into your eye doctor with your symptoms, concerns, and changes in your vision rather than with a diagnosis in mind, that would be best in hopefully not misleading the doctor down the wrong path.
HC: Where can patients go to get more information?
Dr. Shamie: The American Academy of Ophthalmology has a patient resource that is advocated by ophthalmologists around the country. It's an excellent resource of information.