I’ve diagnosed and treated a lot of conjunctivitis in my career as a veterinarian. But, I’ve never had to treat myself for conjunctivitis until this year. What misery! I had no idea inflamed conjunctiva (the pink tissue that lines your inner eyelids) feels like burning sandpaper contacts in your eyes. I never knew that the erythromycin ointment I prescribe commonly to cats feels like Vaseline on your eyeballs and obscures your vision like a greasy oil slick.
After a few days of strange discharge and redness in my eyes, I made a hurried appointment with the first ophthalmologist I could find, who saw me in her plush office in Chevy Chase. I explained to her that I has been suffering from the flu when days later my eyes developed symptoms of excessive tearing that progressed to sticky discharge, ocular redness, and burning. The doctor perfunctorily diagnosed me with “pink eye” and informed me that my eyes looked pretty average in regards to pink eye cases she’s diagnosed.
Her manner was not very empathetic, but I took some comfort knowing my condition appeared average. The doctor explained that she would prescribe antibiotic eye drops that “probably wouldn’t do anything for me” because I likely had viral conjunctivitis.
She hurriedly explained all of this while backing slowly out of the room with her manicured gloved hands up in the air. I had to delay her exit with my questions. Will there be a steroid in the drop? (My inflamed eyes were begging for something to soothe the inflammation). And, how many times a day do I have to instill the drop?
“No steroid in the drop; steroids can delay healing.”
And then, “Four times a day.”
(For a drop that probably won’t work and also won’t relieve my discomfort…. Great. Eerily this sounded like stuff I’ve said and done in the past. Can’t give you the relief you need because there’s a tiny chance it could make you worse. So, I’d rather practice doing no harm.)
As I left, she weakly offered, “if you start to have trouble seeing, do schedule a recheck exam”.
It was interesting to be on the receiving end of this bout of conjunctivitis and trip(s) to the doctor. Not only did I earn a new level of understanding and empathy for my patients with conjunctivitis but it really highlighted to me what’s important during a visit to your doctor.
Yes, I got my diagnosis and I got treatment. But, I didn’t really receive care.
I ended up making a recheck appointment a week later with a different ophthalmologist because once again I felt I needed to be seen quickly. The redness and discharge in my eyes had improved a lot, but suddenly I couldn’t sleep because my eyes seared in pain when I closed them.
This second ophthalmologist was outstanding. She greeted me with a warm smile and immediately gave some needed empathy: “Wow, I can hear how congested you are!” And then, “Oh, your poor eyes—they are soo inflamed! “ After her exam, she told me that she was going to remove some membranes lining my conjunctiva. I was nervous, but when the procedure was over I was thankful for the intervention.
Finally, she prescribed me another antibiotic eye drop. However, this drop contained a steroid! She also prescribed me an antibiotic ointment to instill at bedtime and re-wetting drops to use during the day. The coup d’etat was when I asked her how long I should use the drops. She informed me I was coming back for a recheck exam in 3 days at which time she may tell me.
It seems ridiculous that I was grateful that she wanted to follow my treatment. I’ve since been back to her two more times and finally my eyes have healed. Looking back on this experience I know both ophthalmologists were equally well trained and knowledgeable. However, there was a real chasm between what they provided. Diagnosis and treatment are important. But so is listening to your patient and being interested in their results and recovery.
That’s the difference between medical treatment and medical care.
Nicole Cohen DVM graduated from UC Davis School of Veterinary Medicine and completed a 1 year rotating internship in small animal medicine and surgery in northern California before moving to Washington DC. She has worked at Friendship Hospital for Animals as a primary care and emergency veterinarian for the past 10 years.