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Re: E/E: ophthalmology

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----- Original Message -----

> Any specialists out there? At this stage, I am only trying to make sense

> of

> this super-fuzzy scanned fax of a fax of a photocopy that a client has

> sent

> me for provisional assessment. I do know that the patient had catarct

> surgery

> and has an implanted PCIOL in situ, but a lot of the stuff is illegible.

> And

> I have done very little ophthalmology so far.

>

> For example, I can just about make out

>

> V.A. (=visual acuity) 6/24

> IOP (=intraocular pressure) 13

> Cornea with Descemet folds

>

> but then there is something that may or may not be 'deep fundus' (???)

> 'pressure' (???) [something] +2, [something] +

>

> - any idea what those numbers could refer to, in this context?

>

> Many thanks,

>

>

I do a lot of ophthalmology, and the three you mention as solved look right,

but if you could give us a better picture of what you are sure of and how

many letters are missing (or illegible) for your question terms, as well as

more context (are these all exam findings, for instance? -or could this be a

procedure?) it might help.

There is nothing harder than trying to read illegible text via a

description, and so the description at least has to try to portray the

physical layout (apparent number of letters, etc.). Even then, nothing can

be certain, so I sometimes query the client as to " what the hell it says "

(sorry for language, but clients have to stop using poor images instead of

transcribing text! -they are going to end up killing people with

misinterpretations!)

Burns

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Dear ,

You are quite right. Here is some more info.

This is from a hospital discharge report (the patient, a male aged 65,

appears to be taking part in a clinical study, so I assume the sponsor is being

informed routinely of all SAEs/interventions/etc, but I don't know what the

study is about; internal evidence suggests that it's about prostate cancer).

Thank you for any suggestions,

Diagnoses:

-Cataract extraction with IOL: phacoemulsification, Rt

-IHD

-CHF

-TCC of prostate

-Chemotherapy

Discussion:

Had elective surgery to remove cataract in right eye under LA

Lens: B lens + 21.00 D

On discharge:

RE:

Visual acuity: 6/24 with pinhole 6/21

Intra-ocular pressure: 13

Irritated conjunctiva

Cornea central epithelial oedema stromal oedema with Descemet folds.

[Deep?] [2-letter abbreviation, either of which may or may not be 'f']

[1-letter abbreviation]+2, [1-letter abbreviation]+

Pupil round

PCIOL in situ

Disc normalRetina attached

----------------------

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Hello ,

I'm sorry I can't be of any great help with your text, but 's

suggestions echo my thoughts.

's last comment reminds me of a recent question on another site

regarding " amputation de la jambe " , in which one person, claiming to be

a physician, insisted that this could only mean an above-knee

amputation. Very scary indeed!

cheers

Sue

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----- Original Message -----

> Dear ,

>

> You are quite right. Here is some more info.

> This is from a hospital discharge report (the patient, a male aged 65,

> appears to be taking part in a clinical study, so I assume the sponsor is

> being

> informed routinely of all SAEs/interventions/etc, but I don't know what

> the

> study is about; internal evidence suggests that it's about prostate

> cancer).

>

> Thank you for any suggestions,

>

>

> Diagnoses:

> -Cataract extraction with IOL: phacoemulsification, Rt

> -IHD

> -CHF

> -TCC of prostate

> -Chemotherapy

>

> Discussion:

> Had elective surgery to remove cataract in right eye under LA

> Lens: B lens + 21.00 D

>

>

> On discharge:

> RE:

> Visual acuity: 6/24 with pinhole 6/21

> Intra-ocular pressure: 13

> Irritated conjunctiva

> Cornea central epithelial oedema stromal oedema with Descemet folds.

> [Deep?] [2-letter abbreviation, either of which may or may not be 'f']

> [1-letter abbreviation]+2, [1-letter abbreviation]+

> Pupil round

> PCIOL in situ

> Disc normalRetina attached

My sympathies, it sounds like this is really hard to read. I don't have any

brilliant thoughts, but perhaps you could see if the following look

possible:

> [Deep?] [2-letter abbreviation, either of which may or may not be 'f']

Could it be " Direct " instead of " Deep " ? Even if that is the case, I am

guessing, but I see " direct fundoscopy " a lot in such circumstances, and I

remember you earlier thought " fundus " might be in there. I would at least

expect to see some kind of fundoscopy (AKA: opthalmoscopy) done -there are

also " indirect " and " slit-lamp " versions.

> [1-letter abbreviation]+2, [1-letter abbreviation]+

Just from having two readings, this looks as though it could be a left-right

reading, however, just to keep us on our toes, they like to use the latin

abbreviations ( " d " and " s " ), often as os - od (o=oculus) -I forget which one

is always supposed to be first, but they supposedly have to always start

with the same eye -which doesn't mean they all do.

Even if somehow these look perfect, I would suggest a TN saying something

like " illegible, possibly blah. blah. blah " -It sounds as though this is

background information on your document, but I have nightmares about some

doctor operating on me based on an illegible abbreviation.

I hope this helps, sorry I can't be at all certain.

Burns

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Many thanks, .

Bearing in mind the risk of surgery based on highly speculative (no pun

intended) information, stressed by Sue also, I have added a clear TN (and in

any

case, placed square brackets + question marks around these phrases), plus an

unambiguous statement of my opinion of this text ...

Cheers,

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