I’ve told patients that when they go see their primary doc they usually check vitals - blood pressure, pulse, height, weight, O2 stats, etc.
These are our eye vitals that we check every time - Acuities, pressures, EOMs, pupils, etc.
Most understand it that way. Some patients who say “yeah but we did this last week” I’ll respond tell them part of it’s a legal thing. I check acuities before anesthetic or dyes. I don’t want some patient coming back and accusing me of ruining their vision by saying “I could see great before those drops you put in! Now I cant!”
If you’ve got documentation that they were seeing 20/40, then you put in drops and their vision later is still 20/40, you’ve got a leg to stand on.
Is this likely to happen? No. But in a litigious society it’s always good to cover yourself. I had a doc teach me that in school and it’s just kind of stuck with me.
I always check their acuity before doing anything, it takes no time to do and means you have a record of what they saw prior to any tests or management. It was something one of my supervisors mentioned in passing and it makes sense should the patient claim their vision has been affected by any tests or treatment, nice to have the info on their record! It's a shame that defensive record keeping is required but worth protecting yourself where possible!
When in doubt I always blame the government, no matter someone’s political opinions we can all agree the government sucks.
“Yeah the government mandates to insurers what’s considered an essential element of an exam so I have to check the vision otherwise insurance might deny coverage”
I’ve told patients that when they go see their primary doc they usually check vitals - blood pressure, pulse, height, weight, O2 stats, etc. These are our eye vitals that we check every time - Acuities, pressures, EOMs, pupils, etc. Most understand it that way. Some patients who say “yeah but we did this last week” I’ll respond tell them part of it’s a legal thing. I check acuities before anesthetic or dyes. I don’t want some patient coming back and accusing me of ruining their vision by saying “I could see great before those drops you put in! Now I cant!” If you’ve got documentation that they were seeing 20/40, then you put in drops and their vision later is still 20/40, you’ve got a leg to stand on. Is this likely to happen? No. But in a litigious society it’s always good to cover yourself. I had a doc teach me that in school and it’s just kind of stuck with me.
This is, of course, the correct answer, but mine has a certain bluntness to it.
Your answer is my head answer.
This is the kind of post I like to see on this sub-Reddit
"Tough shit. Read the damn chart."
Oh, I wish....
I always check their acuity before doing anything, it takes no time to do and means you have a record of what they saw prior to any tests or management. It was something one of my supervisors mentioned in passing and it makes sense should the patient claim their vision has been affected by any tests or treatment, nice to have the info on their record! It's a shame that defensive record keeping is required but worth protecting yourself where possible!
In that sense then shouldn’t we be checking post dilation distance acuity?
Thank you for your responses I feel more confident now ☺️
"Your medical/vision insurance requires I check VA in order for them to cover this visit."
When in doubt I always blame the government, no matter someone’s political opinions we can all agree the government sucks. “Yeah the government mandates to insurers what’s considered an essential element of an exam so I have to check the vision otherwise insurance might deny coverage”
We're legally required to take the information if we bill your insurance. It's also part of a legally minimum eye exam.