- Welcome
- Topic 1: Background of Ocular Sympathetics
- Topic 2: Elements of the Case History
- Topic 3: Clinical Tests
- Topic 4: Confirmatory and Diagnostic Tests
- Topic 5: Patient Education
- Topic 6: Treatment and Referral
- Conclusion
- HELP
Case 6
A patient entered the clinic for a routine examination with no complaints. His history was unremarkable, except for smoking X 20 years.
During the course of the examination, anisocoria (increasing in dim light) was noted, with the left eye having the smaller pupil. The IPD was 7mm OD, 5mm OS. Due to the possibility of Horner’s syndrome, 0.5% apraclonidine was instilled in both eyes, yielding marked pupil dilation OS, and mild pupil dilation OD. The patient was diagnosed with likely Horner’s syndrome.
Due to the chance of a life-threatening cause, the patient was referred to radiology for a chest and neck X-ray. The patient was told that he had Horner’s syndrome and would need an X-ray to see why, and that he should go to the radiologist Monday morning. The patient confirmed that he would keep the appointment. However, the patient did not arrive for his scheduled appointment. Future attempts to contact the patient proved unsuccessful.
Activity
Using pencil and paper, please compose a paragraph describing the following:
- Why do you think the patient did not keep his appointment?
- What could the doctor have done differently to ensure that the appointment was kept?
- Was the patient education that was provided adequate for this case? Why or why not?
Move on to the next page when you are done.
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