A patient came in to see me recently. He was an elderly man and he had not visited the practice before. He had not had his eyes examined for some time, and his specs were somewhat worse for wear (putting it politely). The examination was unremarkable. He had some cataract, which necessitated me dilating his pupils to examine his fundus adequately, but after discussion he decided he did not want referral for this yet and wanted to try the new spectacles first to see if he could manage with them. All well and good, I hear you say – what’s so interesting about this? Nothing so far. 

However, the patient returned to the practice about six weeks later on a Saturday morning. He had noticed that for the past two days he had seen orange lights in his right eye and could no longer see his hand in front of his face on the right side. I was busy seeing other patients, but – concerned about a possible retinal detachment, and knowing that the local hospital would only see emergency patients if they were triaged first – I told him to sit down and wait and I would see him as soon as I could.