Checking Unfamiliar Medications
Regarding topiramate-induced glaucoma in “Sudden, Painful Vision Loss in a Young, Healthy Woman” (Morning Rounds, November/December), I had a similar ER case in 2001, before warnings were present in the Physicians’ Desk Reference.
A patient with a counterintuitive background (–3.00 glasses and recently dilated by her ophthalmologist) worsened on pilocarpine. I stopped the medication and she improved only by also discontinuing topiramate and starting mannitol—which I carried out while grasping at straws. A check with the manufacturer confirmed topiramate as the likely cause, and the patient is now doing well.
With today’s electronic means of checking drug adverse effects and interactions, a review of unfamiliar medications is always worthwhile, especially when there is a strange presentation running counter to experience.
James P. Weeks, MD
You Can Make a Difference
Ophthalmology has certainly found itself on the front line in scope of practice battles, and one question we hear often in response to our efforts to get more Eye M.D.s engaged in political and legislative advocacy is: Does my involvement make a difference? The answer is absolutely, a message that is loudly echoed by Dr. Hoskins’ “Legislators Do Listen!” (Outlook, October).
For many years, North Carolina has offered a favorable climate for scope of practice expansion efforts by non-MD providers, especially optometry. As a result, our efforts to both promote and preserve patient safety, as well as protect the value of the MD degree, have become high-priority goals.
Regardless of what state you reside in, however, I hope you will take Dr. Hoskins’ message to heart. We need more ophthalmologists throughout the nation to get involved in the advocacy initiatives of state societies and the Academy for the benefit of both your patients and your profession.
North Carolina Society of
Eye Physicians and Surgeons
For information on scope of practice battles in your state, visit www.aao.org/advocacy.
EyeBuild: Giving Back to Our Hosts
I have had numerous opportunities to visit the city of New Orleans over many years of attending the Academy’s Annual Meeting. My wife and I have come to love the city’s potent mix of people, history, food, architecture, music and charm. We were therefore particularly distressed by the destruction wrought by Hurricane Katrina. And a simple donation to the Red Cross just didn’t seem like enough.
We have always believed that one of the best ways to help a recovering city is to make a visit, so we were pleased to hear that the Academy was the first organization to honor its pre-Katrina commitment to hold its convention in New Orleans in 2007. We were even happier to learn that the Academy had arranged an affiliation with the New Orleans Area Habitat for Humanity to offer Annual Meeting attendees an opportunity to participate in 2007 EyeBuild, a volunteer effort to build houses in the residential areas hit hardest by Katrina.
It was an honor to join the hundreds of ophthalmologists and their family members, ophthalmic staff and industry representatives who gave their time to the building efforts in the Upper Ninth Ward and St. Bernard’s Parish.
I hope the Academy will find other opportunities for us to give back to the wonderful communities that welcome us each year.
W. James Bartlett, MD
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