“I can enjoy life again”

Before you went for a sight test, had you experienced any symptoms? How had this affected you in day-to-day life?

Marion Taylor (MT), aged 79, patient: Cataracts were affecting my sight, but the lumps they found in my eyelids hadn’t caused me any problems. With the cataracts, I started avoiding the motorway and not driving at night. I had to give up reading too, which I love, so that upset me greatly. My reading glasses just weren’t working anymore. The lumps had been there for two or three years, easily, and I’ve had eye tests where they hadn’t been flagged as an issue. I just thought it was old age, and it wasn’t affecting me, so I left it. It was only when I went to SpaMedica that the surgeon noticed and advised me to see my doctor.

What did the ophthalmologist find, and how did they explain the next steps to you?

MT: Kenan Damer, the consultant surgeon, examined my eyes during my assessment for cataract surgery, and noticed the lumps. He asked me a few questions about lumps – how long I’d had them and if I’d ever had them looked at. He said it would be a good idea to get them checked out for peace of mind. Afterwards, he contacted my GP and in just a matter of days I had a biopsy at the hospital. The lumps had passed everyone by until Kenan raised it at the cataract assessment, so I was just grateful for that. I knew the lumps had been there a while, but people of my age, we don’t make a fuss, we just get on with things.

Can you describe how you felt during the referral?

MT: I felt a bit worried, but the surgeon put my mind at rest. I had just lost my husband so I was down anyway and wasn’t in the best place to get that kind of news. Naturally, I was worried about what was going to happen. You don’t want to lose your sight. It was a good job that the SpaMedica surgeon was so thorough.

The whole cataract surgery experience was magic. Whilst the procedure was being carried out, I saw a kaleidoscope of colour

Did you have to undergo further treatment and what has been the outcome?

MT: I was referred from my GP to Leighton Hospital. Following that I was sent to Salford Royal, because they are specialists in this area. They found small tumours on one eyelid and another below my eye. I had a biopsy, and after examination, I was relieved that they felt that no further treatment was necessary. The cataract surgery itself has made a big difference – especially driving at night. I didn’t realise how bad it was. I didn’t feel safe beforehand, and now I’m no longer frightened.

Have your views on the importance of sight tests and eye care changed as a result of this experience?

MT: After both my cataract surgery, and my treatment for the growth, I feel very fortunate for my sight and wouldn’t ever take it for granted. I would definitely recommend to anybody that they consult their doctor or optician if they have any concerns about their eyesight.

One thing I think back on is that I should have asked about the lump. But at my age you don’t bother about a pimple. It wasn’t growing so that’s why I missed it. It’s something that could have turned out much worse.

How has the experience changed your life or affected you?

MT: It has made me grateful – to Kenan and the team at SpaMedica, and for my sight. In a way it’s given me a new lease of life. It’s perhaps a combination of COVID-19 being over, and life getting back to normal, but I know how lucky I am. The whole cataract surgery experience was magic. Whilst the procedure was being carried out, I saw a kaleidoscope of colour. I’m really thankful. I can enjoy life again – I’ve just recently returned from holidays in Venice and Lake Garda, and I’m going to Spain soon.

I told her it was better to get it checked to put both of our minds at rest

How has your clinic adapted following COVID-19 to be able to meet the needs of your patients, such as in this case?

Kenan Damer, consultant surgeon at SpaMedica in Newcastle-under-Lyme, (KD): During and after the pandemic we had to accommodate more patients in our theatre to help reduce the pressure on the NHS, while simultaneously maintaining our high standards of patient care, which is always our priority at SpaMedica.

What did you identify during the consultation and what was your reaction?

KD: I saw the patient just before her surgery and I noticed a skin lesion on her lid margin during a simple inspection, then confirmed my suspicions under the microscope in the theatre. I suspected a basal cell carcinoma (BCC) lesion, which is a slow-growing local skin cancer. I concluded the lesion needed further inspection and a biopsy by an oculoplastic surgeon.

How did you approach explaining what you had identified to the patient?

KD: I asked the patient a few questions about the history of the lesion and if she’d had it looked at by a specialist. Then I told her it was better to get it checked to put both of our minds at rest, as lids are not my area of expertise.

What were the next steps that you took, and what was the significance of these steps to this case?

KD: After performing Marion’s cataract surgery, I wrote an urgent referral letter to the patient’s GP asking them to refer her to her local oculoplastic surgeon. The wonderful team at SpaMedica made sure the letter reached the GP in no time.

When did you hear about the results of your referral and how have you been involved since?

KD: When I saw Marion for her second cataract surgery a few weeks later, she expressed how happy she was with our team’s actions and intervention.

What would be your three top tips to other practitioners when making a referral?

If you have any suspicions or concerns about a patient’s care and safety, even if it's not in your area of practice or expertise, make sure you raise and act on those concerns

If you are not sure or don't know what you found during a patient’s examination, always ask for help or a second opinion and don't ignore or dismiss it
Follow up to ensure that any referrals reach their intended destination quickly, and that the appropriate action is taken from there.