“It could have so easily been overlooked and my retina could have detached”

What led you to go have an eye test? Before you went for a sight test, had you experienced any symptoms and how had this affected you in day-to-day life?

Jean Bourne, 75, patient (JB): I’m not aware that I had any symptoms but because I only have peripheral vision in my left eye, which is down to wet macular degeneration which occurred about two years ago, I’m very conscious of looking after my right eye.

My right eye has a cataract forming and it is early days, but I obviously want to keep an eye on it. So instead of waiting for the regular routine check-up, I decided to go along off my own back and have the usual sort of retinal scan. It was at that time that Alex spotted something a bit untoward.

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

JB: Alex saw something in the very corner of my retina. She wasn’t quite sure if there was a problem or not but she kept looking and looking at it, because it was in the far corner. That’s when she wrote a referral for me to attend the hospital, St Richards.

Getting older, you expect aches and pains in your joints, but you forget about the possibility that your eyesight can also fail in such a dramatic way

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

JB: On going to St Richards, the consultant spotted that I had a tear in my retina, which could have detached in two to three weeks’ time. That was extremely scary, because I would have been blind for that moment.

I had to have laser surgery straight away. It was quite unexpected. While I was there, the consultant actually phoned Alex to congratulate her on spotting it, because it was very important and a very good spot. I came back home very relieved to have gone along when I did. I went down to the local florists and took Alex a huge bouquet of flowers.

I’ve been back since to have check-ups and it has all healed perfectly fine.

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

JB: Naturally, of course it has, yes. When you’ve only got full sight in one eye, it is important to look after that and to maintain it because while I have that, I’m still able to drive.

Getting older, you expect aches and pains in your joints, but you forget about the possibility that your eyesight can also fail in such a dramatic way.

When you’re a pensioner, you’re not going to get charged for these eye tests and scans necessarily, so why not look after your sight? It’s so important

How has the experience changed your life or affected you?

JB: Having only peripheral vision in one eye does change your life in little ways. It is acceptable, and when you are aware of it, then you adjust. I don’t always judge distances very well. If someone was to hand me something, I can’t necessarily put out my hand and grab it. It’s just the little things.

If other people experience any sort of problem, or have any concerns, I would say: go along and get it checked out. Hopefully, you have an optometrist who is sufficiently experienced to spot these things. It could have so easily been overlooked and my retina could have detached. I could have been driving at the time. The consultant expressed the urgency of that.

When you’re a pensioner, you’re not going to get charged for these eye tests and scans necessarily, so why not look after your sight? It’s so important. For a lot of people, if there’s not a problem, they probably don’t think about it, and it’s not until that problem arises that they suddenly become aware: ‘Oh, I wish I’d done this sooner.’

I’m very thankful to Alex. She was a fairly new member, but I’d recommend that opticians to anyone now because she did such a wonderful job in spotting that for me. I’m very fortunate.

The consultant said that I’d referred a patient, who was sat in front of him, and it was quite a hard tear to spot so he wanted to say well done for seeing it

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

Alexandra Allen, optometrist at Walsh Opticians and Hearing Care, a Hakim Group independent practice (AA): Jean booked in for a routine appointment. In history and symptoms, we asked a series of routine questions and she said that, when the light wasn’t good, she could see a shadow in her right eye that she couldn’t always see through. It was something that she had noticed more in the last couple of days.

I then, instead of doing the normal things that you do in an eye test, decided to do a health check instead. So I dilated the patient and found that there was, what looked to be, a tear in her peripheral retina.

I was quite concerned about it, with this being her only seeing eye. I’m the only person that is in the practice all the time and I’m fairly new to it. Sometimes you’d quite like to have someone else here to ask. But you just have to go: “No, I need to get that sent to the hospital right now.”

How did you approach explaining what you had identified/suspected?

AA: It's always quite difficult in conversations with patients to make sure you get the right balance between being serious enough so that they attend hospital appointments, but without scaring them. It was important to get across to her that it was it was quite concerning that she did have a tear.

I said to the patient that there was an unusual area of pigment in the back of her eye that could possibly be a tear. Because what can happen with a tear is that it can lead to a retinal detachment, which is kind of the worst case scenario, and with this being her only seeing eye, it is quite important that we get her seen quite quickly. I explained that I’d be sending an urgent referral to the hospital.

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

AA: The process here is we phone and then send an urgent email referral. I wrote a referral letter, gave a copy to the patient, and sent it to the urgent referrals to be triaged by a nurse. I told the patient that that they would receive communication from the hospital when it had been triaged. I then say to the patient that if they’ve not heard anything, within a week to 10 days then to get in touch, and then I’ll chase it for them – just to give that safety net to make sure they do get seen.

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

AA: The consultant from the hospital actually phoned the practice. I was in clinic with another patient at the time, and one of the receptionists came upstairs and said: “The consultant from the hospital is on the phone and wants to speak to you.”

The consultant said that I’d referred a patient, who was sat in front of him, and it was quite a hard tear to spot so he wanted to say well done for seeing it. He also said he was going to laser it, right there and then. It was really lovely, and I was quite taken aback by it, to be honest.

Then the patient then came in later that day with flowers and to say thank you. That was really lovely. Jean is getting on really well now, which is good.