NHS. Entitled to see actual ophalmologist I'm referred to?

[CharlieGreenEyes]

Sorry if this is a stupid question. I wanted to know if I have to right to be seen by the opthalmologist I was referred to.

I was referred to someone (by coincidence I've seen them recommended on here). I've now had two appointments but both times was seen by someone working under him (on his team).

This wouldn't have been a problem but although both were nice (unlike the very rude and dismissive opthalmologist I first saw) neither seems to know much about my problems.

All I know is I have dry eye, MGD and blepharitis. Things are not better one year on from first seeking help (I've had the problems for longer).

I've still not had the chance to sit down with an opthalmologist, list my symptoms and discuss possible causes. I have various possibilites I want to explore and be tested for but haven't had the chance.

I don't know if I have the right to insist on being seen by the actual person I was referred to, and even if I can whether I should. I don't want to come across as too pushy or difficult.

Would it be worthwhile getting my MGs examined?

[lizlou29]

Hi CharlieGreenEyes. Is the person you were referred to the head of clinic? This happened to me and I saw so many other ophths who would just tell me to use more drops, it's only dry eye not a vision problem etc. In the end I wrote to the secretary of the ophthalmologist I was actually referred to stating my concerns and I got to see him. I go every two months and even now I still get called in to see someone else and I have to say no, I want to see my regular ophth as I feel it's important to have continuity. It does mean that I sometimes have to wait a long time as he generally handles complex children's cornea cases. I'm happy to wait. My ophth actually agrees that I should see him every time, it's just a bizarre way the appointment system works. Perhaps you could write to your eye clinic and ask to see the specific ophth. Sometimes you have to push a bit.

[CarlyS123]

I saw the head of clinic on my 3rd appointment, I think they try and see the patients who have been there for a while and are not getting anywhere. Also if you have a reason to be difficult then be difficult! It also helps to be a bit prepared so that they can't send you away and telling you to do something stupid and come back in 3 months. Once an ophthalmologist told me to try boiling a kettle in my room to add moisture and come back in 3 months to tell me if that helped -_-
I'll list the things they have sent me away to do that have watsed my time, if you can go to your next appointment and say you've done all these then they are forced to do something more.
Say that you've already tried loads of eye drops (drug store and prescribed) and although they help the relief is not good enough for you to function. Tell them you have also tried the eye ointments like lacrilube. You have done the heated mask for a few months and massaged your eyes then used an eyelid hygiene solution like blephasol. You have bought a humidifier and you have tried omega 3 supplements.
If you can get all this done by the time you next have your appointment then they have to start doing further investigations and further treatments. If you tell them all this and they try and fob you off with more drops you just have to tell them straight out that its not good enough and you want to see the head of clinic or someone who specializes in dry eyes at the clinic.

[CharlieGreenEyes]

Thanks for the advice, Lizlou and Carly.

Yes, the person I was referred to is the head of the clinic. Both of you have given me some really good advice and I really appreciate it.

I think I just need to be more assertive - and I'm not very good at it, so I'll have to really force myself. I did try last week and thought I was prepared and would be confident. I think it didn't help that the person I saw had to go and see another patient several times whilst seeing me (I'm guessing a trainee or junior doctor needed their advice). I felt bad for him being so busy so didn't want to push him too much, but I think it made it hard to push for what I needed because I'd start saying something then he'd have to leave!

I'm going to properly prepare for next time. I'm going to type out notes so they are neat and easy for the specialist to read (because I have already tried most of those treatments you mention except for a humidifier). It seems like mine is a familiar story - being fobbed off with drops again and again. I actually first mentioned my eye problems several years ago to my optician (after a new contact lens fitting) and kept getting brushed off with drops. I saw several opticians over the past few years and each time was told there was no problem wearing contact lenses (despite them hurting!) and dry eyes were normal and just buy OTC drops.

Carly, Maybe I'll be like you and see the person I was referred to next time because that will be my 3rd time! I'll see how things go with the optimmune but if things haven't improved I know I'll have to assert myself better.

Thank you again for replying. I feel better knowing people understand and giving me the confidence to push for what I need.

[lizlou29]

When i see my ophth the appointment is constantly interrupted with junior docs etc checking something with him. It's a bit annoying but I'm used to it now.

If you can tolerate Optimmune them that's brilliant. I couldn't as it burned too much but it seems to help a fair amount of people. Good luck!

[cathy8889]

Hi lizlou

Hoping you can give me a little advice please. I would like to have regular appointments like you to see how things are going and to just feel like my condition is being monitored. I just feel like I am being left to rot. I was just wondering if you asked to be seen every two months of whether your consultant arranged this? I'm just at rock bottom again and I don't know what to do, wish I'd insisted on plugs at last appointment, feel like no one is listening to me and giving me the bare minimum to get better.

Thanks

Hi CharlieGreenEyes. Is the person you were referred to the head of clinic? This happened to me and I saw so many other ophths who would just tell me to use more drops, it's only dry eye not a vision problem etc. In the end I wrote to the secretary of the ophthalmologist I was actually referred to stating my concerns and I got to see him. I go every two months and even now I still get called in to see someone else and I have to say no, I want to see my regular ophth as I feel it's important to have continuity. It does mean that I sometimes have to wait a long time as he generally handles complex children's cornea cases. I'm happy to wait. My ophth actually agrees that I should see him every time, it's just a bizarre way the appointment system works. Perhaps you could write to your eye clinic and ask to see the specific ophth. Sometimes you have to push a bit.

[lizlou29]

Hi Cathy889

Well last year the pain from the dryness/inflammation was so bad that i was going every 4 weeks as NOTHING was helping. As things got a tiny bit better we increased to every 6 weeks now it's every 2 months as I have the gland expression done and they don't like to do it more often than that. I've tried nearly every drop and med that could possibly help so now I'm down to the expression plus Azyter one week per month. I think it's because I have a good, sympathetic ophth before him they'd always say come back in 3 month's time and I'd inevitably have to make an emergency appointment in the meantime. I've dealt with rude reception staff and the head nurse there pretty much hates me as my ophth confronted her when she told me i was coming in for just dry eye. He told her all the different elements to my condition. Now she just ignores me but i don't care any more. The rest of the nurses and my ophth's secretary are great. My appointments always ended up being cancelled i got more forceful as i was fed up being fobbed off when i have a life-changing always painful condition. If i need advice in the meantime I'm lucky that i can email my ophth.

[CharlieGreenEyes]

When i see my ophth the appointment is constantly interrupted with junior docs etc checking something with him. It's a bit annoying but I'm used to it now.

If you can tolerate Optimmune them that's brilliant. I couldn't as it burned too much but it seems to help a fair amount of people. Good luck!

Thank you! The optimmune has burned but I'll keep going a bit longer and see if I can cope.

I don't mind the Ophth being interrupted. I actually felt bad for him as he seemed so overwhelmed and busy. But the problem was that it seemed like the times he went away were included as part of my appointment. I only really got about 5 mins to speak with him and didn't get a chance to discuss properly the ongoing situation, etc and insist on a more thorough examination.

I think it was partly my fault. I felt bad for him and when he returned the second time, I asked if he needed to finish the appointment (I said I was sorry to keep him). I shouldn't have done that because although I understand him being called away, it's not my fault and shouldn't have stopped me getting my time with him. I know that now - always realise what to do and say afterwards!

I know I need to be more assertive. I don't want to be seem as a problem patient but it's been going on for so long now and I first tried to get help a year ago, but I still haven't really been seen properly yet. Btw, the reception staff seemed rude where I was too! One seems okay but disinterested but the other one seems annoyed whenever I speak to her (even just to say I had arrived for my appointment!). I suppose if things done get better and I have to try and push to be seen by the head of clinic (who I was referred to), the staff will be even more unhappy with me! I have to try and think like you and let it roll over me.

Hi Cathy,

I'm so sorry you're feeling like that. I feel a bit the same - like I've been left to rot, even though I am actually getting follow-up appointments! I hope we can both be more assertive. Good luck with getting yourself a follow-up (surely they want to check if the Doxy works?).