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Eye exam challenges in elders

by Isabel Fawcett

After experiencing a loved one's dreadful eye exam visit, this caregiver started dreading her mother's next scheduled eye appointment. Ophthalmology technicians and other medical support staff can encourage elders and caregivers alike.

I had been dreading my mom's ophthalmology appointment for one reason. She had one dreadful routine ophthalmology visit previously which had burned into my memory.

In the previous eye exam, she clammed up when asked to read letters in the first row in the eye chart on the wall. After repeating the patient instructions and prolonged silence with her back turned to her, the technician asked me, "Have you ever seen anything like [this] in [her] before?"

The question alluded to her not saying a mumbling word while looking at the eye chart, smiling, and making anxiety-laden hand gestures. I immediately recognized that she was merely having a human reaction to the demeanor of the technician and her nervousness at any doctor's appointment.

Agony of Eye Exam Defeat

I left her nightmarish eye exam dreading her next scheduled appointment and encounters with the same technician. Though between a rock and a hard place, I encouraged my mom as we walked back to the car. I told her that she had done her best. I understood her unexpressed frustration (rock) of being talked to in a condescending manner by a total stranger who offered no encouragement or friendly words. Not that a technician is paid to encourage patients (hard place.)

Elder Preparation for Appointments

Mom's next scheduled ophthalmology appointment rolled around in no time. My feelings of dread remained. En route to the appointment I started joking with her. I informally encouraged her to not be afraid to speak up, even if she needed to say on occasion that she could not see a letter(s) on the eye chart.

As I drove, I randomly pointed ahead, or to our right or left, saying, "Now, Mrs. F…, please read the top line of that sign in the distance. What do you see?" Mom read entire words, instead of calling out individual letters, which made me laugh. I cheered her on, reminding her that she just needed to read each letter instead of words.

For most of the ride, I repeated the I-point-you-read exercise as we rocked the car with laughter and she continued reading whole words merrily. I struggled to read the same words and letters from the same distance.

Much as I loved her defiance and laughter, I couldn't help but worry when she told me that she would stick to reading words "...because I see words, and I'm reading words. Don't tell me what to read," she said, laughing. In a feeble last-ditch effort, I pointed at license plates asking Mom to read them. The switch to license plates did the trick as she called out letters instead of words. Minor detail was that she read numbers as the totality of the 3 digits instead of calling out each digit. One-out-of-two wasn't bad, though. As there are no numbers on eye charts anyway, who really cared? Not I.

My caregiver-as-life-coach work was complete.

A+ For Reading

She passed her eye chart exam reading with flying colors that day. It helped that the new technician took the time to chit-chat with a patient who always smiles back at friendly faces everywhere. As we left the doctor's office and got onto the elevator, she started reading emergency instructions in fine print on the elevator.

"Psst!" There are people in line behind us waiting to get onto the elevator.

Mom read every sign on the drive home. Caregiver mission accomplished. Wonder what my next caregiver mission might be?