Myopic degeneration/lacquer crack

[wwhmustaine]

I was recently diagnosed with myopic degeneration in my right eye, and told that I have a lacquer crack in that eye. I am 40 years old, and as a practicing attorney, am obviously concerned that my condition will either worsen in my right eye, or also develop in my left eye, thus rendering me essentially disabled.  Is there any treatment, therapy or surgery available for my condition? If not, what are the best preventative measures to take to ensure the condition does not progress in my right eye or begin develop in my left eye?  Lastly, what is the likelihood that the condition in my right eye will worsen, or that it will also develop in my left eye?  In other words, is it likely that I won't notice any significant decline in my condition over the next few decades?

[kg17]

I think the money issue is relevant simply because it is a motivating factor for most people.  When reimbursement is based on the number of patients seen and procedures done, rather than the quality of the outcome, altruism merely becomes a footnote for many docs.  

It is a long-standing joke in med school (here in the U.S.) that those who can't practice, do research.  That perception is tied, at least indirectly, to the amount of money a practicing physician can make as opposed to the Ph.D researcher.

[dukey]

It's the laziness I have a problem with. I don't really care how much they get paid but they should do their best for the patient at all times. If you have a patient who walks in and you only have a basic understanding of the condition, you should either fess up and refer them to someone experienced or, even better, go out of your way to brush up on the area, even if that means going to the dreaded library. I do not think that is an  unreasonable expectation and if I was an MD, that is where I would get the most satisfaction.  

Science and medicine are linked unconditionally. They both need each other to move forward.  

[kg17]

Just back from my 6 month retinal visit from the most reputable retinal specialist.  I have to concur with Dukey.  The biggest problem I see with healthcare, in general, is the ignorance of MDs - they really do fail to keep up on the research literature.  Perhaps it's because I had research crammed down my throat for 6 years of grad and 2 years post-grad, that I just don't understand how clinicians can treat without attending to the literature first.  But then again, an MD's income isn't based on any individual patient's outcome or knowledge of a relatively infrequent disease.  Additionally, accurate interpretation of available research isn't required either, whereas a scientist's entire career depends on it.

In my opinion, I believe that MD clinicians should not be paid more than the PhD/MDs who do the research.  Our system is far too lopsided.

[dukey]

"The way it was explained to me was that an examination of my eye after dilation would make them 98% sure that there was no CNV, and the dye test would push that # up to 100%"

There is your problem. That is ignorance and arrogance in my opinion.

[dukey]

I'm pleased for you, but feel bad for you at the same time. I would expect the Avastin to clear it up quite easily. Be thankful, a few years ago this would not have been possible. Honestly, this stuff really isn't that complicated and it really amazes me how grossly negligent some of these docs are. Patholigcal myopia CAN and WILL progress quickly in certain people and requires specialist care. It can literally change overnight which is why monitoring and EARLY agressive treatment is so important.

I swear I could walk into any retina office and do a better job than 50% of these docs without even touching the patients. You order tests, look at the results, read the literature and away you go. It's a joke and it may cost you a few lines at vision. I guarantee you it was visible when you first started to notice symptoms. Myopic CNV can be extremely subtle. They should READ THE LITERATURE.

Oh well...........    

[kg17]

I think the odds are in your favor.  You received the shot in a timely manner.  It's very wise that you have sought to educate yourself, and this forum is a good place to start.  I'm glad you went back and insisted to be checked again.