Specialty Area: Ophthalmology
Description of Specialty: Ophthalmology is the field of medicine specializing in the
diagnosis and treatment of disorders of the eyes and visual system.
1. Diagnosis: Refractive Error/Eye Glasses
Questions that should be asked:
- For anyone: Should I expect these new glasses to correct all my symptoms?
- What problems might remain?
- Should I expect any difficulties adjusting to these glasses?
- How can I minimize those difficulties?
- How do I know if the glasses have been made correctly?
- Do I need to wear the glasses all the time?
- If the patient is a child: Will wearing glasses make my child's eyes better?
- Will wearing glasses make my child's eyes worse?
- What kind of frames should I get for my child?
- How do I know they fit properly?
- What lens material is best for my child?
- When should my child wear these glasses?
- Do you have a suggestion for a place to get glasses for children?
- You say my child is farsighted, but you aren't prescribing glasses. Why not?
2. Diagnosis: Presbyopia/Reading Problems
Questions that should be asked:
- I used to read fine. Why am I having trouble now?
- Should I get bifocals or separate glasses for reading?
- Will these glasses be good for (whatever activity is important to me in everyday life)?
- How does the invisible bifocal (progressive bifocal) differ from the bifocal with the
line?
- Which would be better for me?
3. Diagnosis: Glaucoma
Questions that should be asked:
- Any time: Do I have open angle or narrow angle glaucoma?
- What is the difference?
- What causes glaucoma?
- How does glaucoma damage sight?
- Am I going to lose my sight?
- How do I know if treatment is working?
- I understand the eye pressure should be kept below a certain level -What is the target
pressure for me?
- Is this hereditary?
- Are my children at risk for glaucoma?
- At what age should they be checked?
- Do I need to limit my physical activities?
- If eye drops are prescribed: What is the best way to instill eye drops?
- How long will I need to take eye drops?
- Will they cure my glaucoma?
- Are there generics of these drops, and are they alright to use?
- Are there any medications, over-the-counter or prescription, which I should avoid
taking?
- Should I expect any side effects from the eye drops which you prescribe?
- Should I tell my internist that I am taking these eye drops?
- Should I take the eye drops the day I come for my next appointment?
- If surgery is recommended: Why do you feel surgery is necessary?
- What other alternatives might there be?
- How does the operation lower the pressure in my eye?
- What are the risks of doing the operation?
- How long will I be limited in my activities after the surgery?
- Will I need help after the surgery?
- Will I still need glaucoma eye drops after the surgery?
- If the doctor says you have narrow angles: What does narrow angle mean?
- What are the symptoms of angle closure glaucoma?
- If I think I might be having an attack of angle closure, how soon should I contact the
doctor?
- How would I contact the doctor if the office is closed?
- Do I need medicine for this problem?
- Do I need a laser operation for this problem? (If laser is recommended, ask how laser
works for this problem.)
4. Diagnosis: Cataract
Questions that should be asked:
- What is a cataract?
- What causes cataracts?
- What is my vision now?
- Can you improve my vision by changing my glasses, without performing cataract surgery?
- If so, how long will I be able to see well with the new glasses?
- Why do I have more trouble seeing in bright sunlight or when headlights hit my eyes?
- (if these apply to you) Should I be driving?
- How will I know when it is time to have cataract surgery?
- Is there anything wrong with my eyes which might keep me from seeing well after cataract
surgery?
- What are the risks and complications associated with cataract surgery?
- How long will I be limited after my cataract surgery?
- Will I need help after the surgery?
- Will I need to use eye drops after my operation?
- Will I need glasses after I heal from the cataract surgery?
- When will I get them?
5. Diagnosis: Macular Degeneration
Questions that should be asked:
- What is the macula?
- Do I have dry macular degeneration or wet macular degeneration?
- What is the difference?
- Will I go blind?
- Are there glasses which will help me to read?
- Are there glasses which will help me see to drive?
- Is there any magnifier which would make it possible for me to read?
- How difficult is it to use that magnifier?
- What can be done to keep my sight from getting worse?
- Should I be taking antioxidants?
- What is the likelihood surgery will make me see better?
- What are the risks that surgery will make my vision worse?
- How long will it take for me to recover after the surgery?
- Are my children likely to develop macular degeneration?
- Are there any limitations on my activities?
- . Can I drive?
6. Diagnosis: Blepharitis/Chalazion/Eyelid Infection
Questions that should be asked:
- Is this infection contagious?
- How can I eliminate the redness from my eyelid?
- How long should I expect this problem to last?
- Are there any side effects or risks from the treatment you suggest?
- What problems might occur that I should call you and report?
- How can I keep this problem from recurring?
- Can I wear makeup?
- Should I discard my present makeup?
- Is this problem from allergy?
- Can this problem affect my eyesight permanently?
- .If I have a lump in my eyelid, does the lump need surgery and could it be cancer
? 7. Diagnosis: Conjunctivitis/"Pinkeye"
Questions that should be asked:
- What is the difference between conjunctivitis and pinkeye?
- Am I contagious?
- How can I avoid spreading this infection to others? How will I know when I am no longer
contagious?
- Can I go to work?
- How can I get rid of this infection?
- How long should I expect this infection to last?
- What is the best way to instill eye drops?
- Is there any risk of side effects from the eye drops you have prescribed?
- How will I know I am having a side effect from the eye drop?
- What will happen if I don't use the eye drops you have prescribed?
- Will this infection harm my vision?
8. Diagnosis: Iritis/Uveitis
Questions that should be asked:
- If my eye is not infected, why is it red?
- What is the difference between inflammation and infection?
- What is causing my eye to be inflamed?
- Do I need to have my internist test for disease elsewhere in my body which might be
causing my eye problem?
- Will I lose the vision in my eye?
- How can the inflammation be controlled?
- Can it come back again, after this episode is resolved?
- Is there a best way to instill the eye drops which you prescribe?
- Are there any side effects from the medicine you are prescribing?
- .What would happen if I don't take the medicine?
- .How soon will my eye be feeling better and my vision get better?
- .Can I work while I am treating this problem?
9. Diagnosis: Floaters/Light Flashes
Questions that should be asked:
- What is a floater?
- Why do I see light flashes?
- Will the floaters and light flashes go away?
- How soon?
- Are there any limitations on my activities?
- For how long ? Will this lead to retinal detachment?
- Do I have a retinal hole or tear now?
- Are there any symptoms which would indicate that I should return for another retina
examination before the next scheduled appointment?
10. Diagnosis: Retinal Detachment
Questions that should be asked:
- What is the retina and what does detachment mean?
- How can the detachment be repaired?
- If my vision is poor in the eye and I need surgery, will I see after the operation?
- How long will it take for my vision to get better?
- If my vision is good in the eye, why do you need to operate?
- What will happen if you don't operate?
- How long will I be limited after my surgery?
- Will I need help after the operation?
- How long must I stay off work? Will my other eye get a detached retina?
- If you do not specialize in retina work, should I see a retina specialist?
11. Diagnosis: Dry Eye
Questions that should be asked:
- Why are my eyes dry?
- Is there a disease causing my eyes to be dry?
- Will my eyes always be dry?
- What can I do to make my eyes feel better?
- Will I need to use artificial tears forever?
- Should I use artificial tears with or without preservatives?
- Will an eye ointment help?
- How do I use it?
- Is there any medicine which can make me produce more tears so I don't need artificial
tears?
- Are there any medications, over-the-counter or prescription, which might make my dry eye
problem worse?
- What is punctal occlusion?
- Do I need that?
- Should I tell my internist that I have dry eyes?
12. Diagnosis: Epiphora/Watery Eye
Questions that should be asked:
- If the patient is an infant: Why is my child's eye watery and full of mucus so often?
- Can you explain for me how tears are supposed to drain from the eye?
- What does probing do?
- How likely is it to resolve my child's problem?
- How long should I wait before having probing done on my child?
- What are the risks of probing?
- What will happen if my child's tear duct is not probed?
- Do you do probing in your office or in an operating room?
- Why do you chose that location?
- If the probing does not eliminate the tearing, what is the next step?
- If the patient is an adult: Can you explain for me how tears are supposed to drain from
the eye?
- Is my tearing problem from making too much tears, from weak blinking, from blockage of
eyelid tear drainage channels, or from blockage of the tear duct?
- What can be done about that problem?
- Can you prescribe something to make me produce less tears to reduce the watering of my
eye?
- What will happen if I don't do anything more about this problem?
- If surgery is recommended: Explain how the surgery will help me.
- What are the risks of the operation you are proposing?
- Will there be a scar?
- How will I be limited after the operation, and for how long?
- Will I need help after the surgery?
- Is this an operation you do frequently?
13. Diagnosis: Strabismus/"Crossed Eyes"
Questions that should be asked:
- If the patient is a child: Why are my child's eyes misaligned?
- Is the problem in the eye muscles or in the brain?
- Will glasses help straighten my child's eyes?
- Is my child's eyesight impaired?
- Does my child see double?
- How does the misalignment of my child's eye affect his/her life?
- Will he/she be able to read, learn, play sports, drive a car, and work like other
people?
- Can my child's eyes be straightened without surgery?
- Will prisms help?
- What are they?
- If the patient is an adult: Why am I seeing double?
- Why are my eyes out of line?
- Is the problem in the eye muscles or in the brain's control of the eye muscles?
- Will I get better if I don't do anything?
- Do I need prism?
- How would that help me?
- If surgery is recommended: How will this operation help me/my child in everyday life?
- What is the success rate for straightening eyes with surgery?
- What do you do to the eye muscles in surgery?
- How do you get to the muscles?
- What are the risks of strabismus surgery?
- Will I/my child need glasses or patching after the operation?
- Is this an operation that you do frequently?
- What limitations are there after surgery?
- How soon after surgery will I/my child be able to resume normal activities, such as
work, driving, school, and sports?
14. Diagnosis: Amblyopia/"Lazy Eye"
Questions that should be asked:
- I thought "lazy eye" meant crossed eye. What do you mean by "lazy
eye"?
- My child's eyes look normal. Why can't he/she see normally?
- How will Amblyopia affect my child's everyday life?
- Will he/she be able to read, learn, play sports, drive a car, and work like other
people?
- Why can't glasses correct my child's vision?
- Can Amblyopia be treated?
- How? How can I make my child leave the patch on his/her eye?
- Can I put the patch on my child's glasses, instead of on the skin?
- Must the patching be done continuously, or can I break up the time in several sessions
in a day?
- Must I patch every day?
- What can I do about the skin rash my child gets from the patch?
- If the child's eyes are crossed, can you straighten my child's eyes with glasses or
surgery, will the Amblyopia disappear, and his/her vision become normal?
15. Diagnosis: Diabetes
Questions that should be asked:
- How can diabetes harm my sight?
- What is neovascularization?
- Do I have neovascularization?
- What is clinically significant macular edema?
- Do I have that problem?
- How long does it take for diabetes to damage my eyes?
- Will I lose my sight?
- Does keeping my blood sugar controlled protect my eyes from damage?
- What is a flourescein angiogram, and why would you want me to have that test?
- How do you treat diabetic eye problems?
- How do I know when I need treatment?
- How often should my eyes be examined?
- How does laser therapy work to help my eyes?
- Does laser therapy stop the progression of diabetic eye problems?
- What are the risks of laser therapy?
- How often should my eyes be checked?
16. Diagnosis: Headache
Questions that should be asked:
- Is anything about my eyes or eyeglasses causing my headaches?
- Can you modify my eyeglasses and eliminate my headaches?
- If my headaches are not from my eyes, what else might cause them?
- What other tests should I have performed?
- Should you, or my internist, or a different doctor, do those tests?
- Do you think my headaches are migraine?
- What is migraine?
Barry Milder, M.D. Clinical Associate Professor, Department of Ophthalmology Washington
University School of Medicine St. Louis, MO