18. Re-examination after referral

13 November 2020

Should you re-examine a patient you have recently referred if their symptoms worsen?

Scenario

Ann Chase, aged 82, comes to you complaining of diplopia. This had been present for about nine months, but has been worsening in the last few months which prompted Ann to attend for an eye examination. You referred Ann urgently, but the hospital considered this to be non-urgent (as the diplopia had been present for some time) and sent Ann a routine three month appointment. Ann then returned to you – before she had been seen by the hospital – to buy new specs, hoping that they would relieve her symptoms. You stressed that the prescription you found was similar to the one she was already wearing, and having new specs would not improve her symptoms. You also told Ann that if the hospital prescribed prism, she would have to have any specs remade.

Ann was not happy with this and became very agitated. Ann reported that her vision had been getting worse every day since her eye examination. Ann was so worried about her eyes that she went to her GP and the local A&E department. She then returned to see you demanding that you re-check her eyes because she had been ‘told by the GP and A&E department that this was the requirement’.

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