“I was just happy to hear that Poppy-May was alive and well and still smiling”
OT heard how a referral made by optometrist Mrudang Patel led to nine-year-old Poppy-May receiving urgent brain surgery
29 June 2023
What led you to take Poppy-May to have an eye test? Before you went for a sight test, had she experienced any symptoms and how had this affected day-to-day life?Kayleigh Leeds, mother of nine-year old Poppy-May (KL): Poppy-May had mentioned a bit of blurred vision when she didn’t have her glasses on. We didn’t realise at the time, but she had also been experiencing a few headaches at school. The school thought it was due to the noise and so gave her headphones.
What did the optometrist find, and how did they explain the next steps to you?KL: In February this year we went in for a check-up. Mr Patel said that he had found swelling at the back of the eye, explained as papilledema. He told us he was going to make an urgent referral to Ashford Eye Clinic.
Can you describe how you felt during the referral?KL: So worried. I just felt absolutely sick. Mr Patel at Scrivens was absolutely amazing. He was so quick.
We would tell everyone: get your eyes checked. At the end of the day, it saved our little girl’s life
Did Poppy-May have to undergo further treatment and what has the outcome been?KL: The formal outcome was hydrocephalus.
We had had the eye test on the Thursday and were called into William Harvey Hospital in Ashford on the Monday where Poppy-May had some checks and images taken. We had to stay overnight in the children’s unit, and had further blood tests and an MRI before we got sent home.
That Friday, we woke up to around 15 missed calls. They explained that Poppy-May was too unsafe to stay at home and we had to go to Margate Hospital as soon as possible. We stayed overnight, and on the Saturday we were taken to King’s College Hospital, London, in an ambulance, where she had an operation early on Sunday morning. She now has a shunt that will remain for the rest of her life.
Poppy-May is now back at school for two hours a day, but she is still very tired. It’s taking its toll on her.
Have your views on the importance of sight tests and eye care changed as a result of this experience?KL: We would tell everyone: get your eyes checked. At the end of the day, it saved our little girl’s life. The consultant at King’s College said there was so much fluid on her brain that she was close to having a seizure that could have possibly killed her. It is so important. I know that people can be frightened or worried about getting their eyes checked, but it is so worth it.
How has the experience changed your lives or affected you?
KL: It has been a scary time. Now that she has had the operation, it’s okay but I won’t say it’s a relief, because we’ve been told it can still come back. We have to be careful and we watch every little thing she does. Everybody has been amazing. We can’t thank King’s College enough, and Mr Patel at Scrivens. We don’t know whether our baby would be with us now, if it wasn’t for him.
What did you identify during the sight test and what was your reaction?
Mrudang Patel, locum optometrist (MP): I noticed a suspected appearance of papilledema in the form of indistinct optic disc margins on the retina via indirect fundoscopy which immediately concerned me to take urgent action.
How did you approach explaining what you had identified/suspected?
MP: I explained in simple terms what I had seen, in terms of the optic disc appearance. I said that, as it can be a result of increased intracranial pressure, I wanted to refer her as an emergency as it can be serious and life-threatening. Poppy-May's parents were understandably concerned but thankful for the explanation and the emergency referral.
It was important to get seen without delay because this can be life-threatening
What were the next steps that you took, and what was the significance of these steps to this case?
MP: I handed Poppy-May's parents a referral letter to take directly to the hospital. It was important to get seen without delay because this can be life-threatening. Poppy attended the local hospital eye service in Herne Bay and was then sent to Kings College hospital in London for brain surgery.
When did you hear about the results of your referral and how have you been involved since?
MP: I was away on holiday and on returning back to work I was told about this case and that Poppy-May had had surgery done or she could have died. I was told that the family wanted to do an article in the paper to raise awareness, and that they wanted to visit me to say thank you. I was just happy to hear that Poppy-May was alive and well and still smiling. I caught up with Poppy-May and her parents when they came in and she gave me a box of chocolates, which was lovely.
What would be your three top tips to other practitioners when making a referral?
- My advice would be for optometrists to keep themselves refreshed with knowledge on pathology presentations of the eyes through education and training
- I would also stress the importance of communication, and explaining in words the patient would understand whilst also being empathetic
- I would stress the importance of knowing the urgency of what the referral is for, as in this particular case, the difference between a routine or urgent referral could have cost Poppy her life.