IT'S ALL ABOUT THE HISTORY

 

Ngozichi, Port of Spain, Trinidad 2014

"Do you have any medical condition? I asked the 65-year-old lady, who had been waiting for an hour to see me. She has no appointment. A  walk-in at 3 o'clock in the afternoon. She has flown from one of the islands- Andros, an island 58 km away by plane Northwest of Nassau without a resident eye care professional. 

A 15-minute journey by flight that costs between 140-200 USD. And 4hr 18 mins by ferry. I had to see her. She is a type 2 diabetic and hypertensive for 15 years. Her last eye exam was four years ago. Knowing her medical history is important, although she is here only for an eye exam. The eye is the window to the body, everything that goes on in the body affects the eyes. So, it's all about history! 

Sometimes patients wonder why you fuss so much about, their medical conditions and the medications they are currently taking. How many times have I heard "I'm just here to test my eyes and get glasses"

Case history is the most important part of diagnosing a patient's problem. An optometrist can tell you exactly what the problem is from the answers you give. But with some patients, Lawd! have mercy! getting those crucial answers is like pulling a tooth. especially when it comes to giving answers to Family ocular and Medical history, and even their own medical history.

So, why are some patients so secretive? Why are they unwilling to reveal a medical condition or that of a family member? Sometimes it has to do with the culture of the people. In some cultures, people are generally open and will give you more information than you need, while in others, keeping stuff close to the chest is encouraged.

When I practiced in Trinidad and Tobago, Patients are willing to give you all the answers and would go down as many generations as you want. In Nigeria, it was like pulling a tooth, it was either because they did not know. Many a time causes of blindness or death were never certain in communities that did not like visiting a doctor.

In the Bahamas, it was the same problem, people were so secretive, many a time, I would reassure the patient, by saying " I am not really prying about their business but, your answers help me do a better job". 

The Haitian patients I encountered did not feel comfortable divulging health history and I often wondered why. Perhaps immigration issues had something to do with it. As it also happens with their names, they often adopted an English-sounding name rather than their French one, to avoid discrimination in the Bahamas.

For any kind of doctor in healthcare, taking history and communication is a cornerstone in Optometrist-patient interaction and the diagnostic process. It starts as soon after the introductions and the patient sits in your chair and continues throughout the course of an eye exam.

So, when next you visit your optometrist, arm yourself with all the medications you are currently taking, both for your eyes and general health. In this day of technology, all you have to do is take screenshots with your cell phone. Knowledge is power!