I just finished a residency in ocular disease and low vision at the VA hospital in Tucson, AZ. Besides filling in on the occasional weekend for other optometrists, I’ve never been completely on my own without a supervising doctor to check in with when I had a complicated case. In optometry school we always heard horror stories of a new optometry/residency grad’s first day and how they had a patient with some crazy, obscure condition. Well, this was my ‘first day’ patient here in Haiti…
These pictures are from the second time we saw her. When she first presented, the left eye was only restricted when looking down and slightly when looking right. Her left pupil was also dilated. With limited medical resources in Cap-Haitien, we sent her for immediate blood work and a basic CT scan of the head. We also advised she see a neuro-ophthalmologist (the closest is about 5 hours away). She preferred to return to us with the results, which were all normal. On return, the restrictions of her left eye had progressed and she could now only look left (as seen in the pictures above). At this point, we were worried she may have an aneurysm compressing one or more nerves leading to her eye and eyelid muscles causing paralysis of those muscles. We again strongly advised she see a neuro-ophthalmologist and also get further testing done to see if she does have an aneurysm.
Her case is a prime example of some of the issues here in Haiti: limited resources and poverty. She spent ~$150 US dollars on her initial blood work and CT scan, which may not seem like much, but for her, was all the money she had; and with the testing being inconclusive, probably seems to her like a waist of money. Now she has to ask her family for money to travel, see a specialist, and get further testing. She will also likely need surgery.
We are unsure at this point if she proceeded with seeing a specialist. We plan to contact her this week to find out and see how she’s doing.
With the harsh reality of this woman’s case, we know that the Lord is the great physician and is able to heal all wounds, big and small. We are praying for her that she will lean into Him as she takes these next steps down the path the Lord is leading her on.
– Dr. Leigha Davis