Re: Is it ethical to charge for a wrong diagnosis?

On Wed, 28 May 2008 11:20:48 -0700, "Don W" <dwilgus@xxxxxxxxxxx>
wrote:


Fuch's is diagnosed by the appearance of the endothelial cell layer.
The presence of guttatta and polymegathism are positive signs.
Corneal thickness measurements are not diagnostic for Fuch's.
Furthermore there are significant differences in corneal thickness
between individuals with perfectly normal unaffected eyes. Corneal
thickness readings of 645 do not suggest Fuch's, only that a persons
cornea is thicker than average. Nothing more. The fact is that most
Fuch's cases, unless they are severe, do not affect a person's visual
acuity that much.

I had wondered if Fuchs' ED might manifest itself thru a pinhole test. Ran
across this link:


This is something that I tried out of curiosity as soon as the problem
was evident. In my case the pinhole makes the vision sharper. This
is to be expected where the problem is in the optics. Doctor said
this behavior with pin hole is consistent with Fuchs'.

http://en.allexperts.com/q/Ophthalmology-Optometry-979/fuchs-endothelial-dystrophy.htm

Topic: Ophthalmology & Optometry

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

Expert: Elliot B. Werner, <B>M.D.</B>
Date: 9/4/2007
Subject: fuchs endothelial dystrophy

Question
I have what's primarily a curiousity question. I was diagnosed with early
Fuchs endothelial dystrophy by my optometrist and was sent to an
ophthalmologist who confirmed it. When the ophthalmologist's technician was
doing the eye exam, she placed a solid thing with pin holes in it in front
of one eye while the other eye was covered. My vision thru the pin hole
thing turned into a mess, instead of the letters on the eye chart, I saw a
bunch of lines like ovals, dots, etc. The ophthalmologist said those were
due to Fuchs. I later decided I wanted a corneal specialist as my primary
ophthalmologist. I asked him about the pin hole thing, as I was wondering
what I was actually seeing, corneal damage, the guttata(sp?) or what. He
said it was probaby just a one time thing, maybe my eyes were dry or
something (I also have dry eye, but keep them well moisturized.)
I am not sure who is correct. This was so striking, I have trouble
believing it was some temporary dry eye artifact. Any idea what it is due
to? Thanks.


.

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