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Monday 21 May 2012
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See how the buck passes when patients wear glasses

28 Oct 2010

Copperfield hates being asked to rubber-stamp referrals, and ophthalmology is always the worst offender

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READERS' COMMENTS

Anonymous,
12 Nov 2010
I do of course appreciate that Copperfield is intended to be tongue in cheek and humorous, but he may be missing an important issue here; is he aware that RCEs are actually excrutiatingly painful for the patient, and definitely not something "that a bit of lid hygiene, some antibiotic eye drops and a sense of humour couldn't handle". Some extra wisdom that he might like to 'pass on to the young folks' (and possibly save them being sued?) – RCEs might well be an indication of serious systemic autoimmune disease because of the link between Sjogren's syndrome (a recognised cause of dry eye and RCEs) and other autoimmune diseases such as antiphospholipid syndrome, rheumatoid arthritis, primary biliary cirrhosis and lupus – any of which might be present in a female patient in middle years (Mrs Brow?), for whom many GPs might be a little too hasty to assume it is 'their age' (prescribe HRT?) or that they are depressed (prescribe SSRIs), either of which will have the most unwanted effect of worsening their dry eyes and mouth.
And wouldn't a letter from a dentist re a patient's dry and sore mouth be equally useful in making bells ring re Sjogren's and autoimmune disease
Best wishes Jay Gibb
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