On the 10th October, I suffered an eye injury which left me blinded in my right eye for several hours. No words can describe the wave of emotions that overcame me during my temporary loss of vision. Currently, my vision is still blurred, but it is getting better day by day and my Ophthalmologist (eye doctor) is confident that I will recover well. Looking back, I’m glad this incident happened as it has given me an opportunity to reflect on my life and the things which are most important to me. My experiences as a patient seeking medical care in a foreign country has also given me some things to think about as I prepare to embark on a career as an Orthopaedic surgery resident. In addition having a medical insurance has come in useful in my situation and I think everyone should buy some form of insurance. I am insured by the NTUC Income PA Assurance scheme (Link here) which will cover my medical expenses.
I was doing my usual pre run stretching with an elastic band when the incident occurred. I was lying on the carpet with one leg in the air with the band around my upper back, looping around my elevated foot so I get a stretch down the posterior chain of my leg. As I was stretching, the band suddenly slipped down and hit both my eyes with great force. The pain was so severe I immediately laid face down, covering my eyes with both hands. When I opened my eyes, all I could see was white. The pain was still unbearable and I closed my eyes again. When I opened them a few minutes later, partial vision had returned in my left eye but my right eye was still a compete white out.
I jumped up and went towards the toilet mirror to see what was happening. It was difficult to examine my blinded right eye as my left eye was also very blurry. I tried to look for any bleeding or swelling could not make out anything. I took a selfie with my phone, hoping that I could zoom in to examine the photo but to no avail.
At this point, based on my limited experience with eye conditions, I came up with several diagnoses.
- My lasik flap which I did 5 years ago may have been dislodged leading to such severe blur white out vision.
- The lens in my eye could have dislocated causing severe blurriness.
- I could be bleeding in the anterior chamber of the eye (hyphema) leading to blur vision
- I could have torn a blood vessel in my eye leading to bleeding in the eye ball (vitreous haemorrhage)
- My retina could be torn? This would be the worse as it meant I would be permanently blind. But I told myself this could not be the case as in a retina detachment, I would experience a black-out.
I basically had no idea what was happening. But somehow despite all my differential diagnosis which I knew would all require an urgent consult with an ophthalmologist, I decided that it was just a bad daze and decided to head out for a run to see if it will go away.
During the run, I kept “testing” my right eye by closing my left eye and trying to convince myself that the vision is getting better. “Hey I can see the shadow of the tree” “Hey I can the shadow of the road sign” was what went through my mind. It was scary.
Alas there was no change in my vision after the 40min run. I could see shadows through my right eye but honestly nothing else. I couldn’t count fingers directly in front of me.
No one was around then in the house, but fortunately my housemate Andrew was just 10minutes away. When he arrived home, he asked if I wanted to go to the Emergency Room or the Urgent Care Facility. The difference was that the ER is much more expensive than an Urgent Care which charges a flat rate of 100-200 dollars. Apparently a visit to the ER can cost you thousands of dollars here in the USA. Fortunately, I was insured by NTUC Income PA Assurance (Link here ) and my expenses would be covered.
I knew that I would need a thorough examination with equipment only available in a hospital, and a consult with an ophthalmologist, thus I decided on the ER. It was a Saturday and the opthalmology clinics were closed as well. We thus headed to the Avista Adventist Hospital in Louisville.
By then, it was about 7am in Singapore then (5pm in USA) and my fiancee Bel was finally awake. I called her and told her about my freak accident. I expected her to panic but she was the exact opposite! She was calm and insisted that I do not panic until the doctors had assessed me.
The quick trip to the ER was a blur both literally and figuratively.
At Avista Adventist Hospital
At Avista Adventist Hospital, the first thing they asked for upon registration was for my insurance card. Most Americans have an insurance card which they have to present upon registration. I was told that it’s a complicated system because some hospitals do not accept certain insurance cards. I feel that the Singapore system is better in this aspect because patients can go straight to the most convenient AnE at any government hospital without having to worry about whether their insurance will cover treatment there. In my case, I paid for treatment myself and will be claiming from my NTUC Income PA Assurance (Link here ).
The ER was rather empty and there weren’t many patients around. It was a far cry from the hustle and bustle that you would see in any AnE in Singapore or even on American TV shows like Greys Anatomy and house. Maybe it’s because Boulder is a fairly small and sparsely populated town.
I was tended to first by a nurse who took my vitals and taking medical history. I was then seen by the on-duty doctor, Dr Oaks and an accompanying medical student. Everyone was really friendly and accommodating, which made me feel more comfortable. This is something I will take away as a doctor in Singapore where we are frequently so hurried that good patient communication goes out of the window. Upon hearing that I was an orthopaedic surgery resident back in Singapore, Dr Oak became more worried as an eye injury could derail my entire career.
She performed all the standard eye tests which I’d learnt in medical school (Eg. Visual acuity, eye pressure) The tests remained inconclusive after 10 minutes of examination. Both Dr Oaks and I had no idea what going on with my eye. The eye may be small, but it’s such a complicated organ. I remember my biggest takeaway during a rotation in the eye department as a medical student was when to refer to an opthalmologist. We agreed that this was something that required specialist opinion.
She left the cubicle to call the opthalmologist on call. I could see her frowning as she talked on the phone. She came back even more worried than before and informed me that I needed to be transferred to another hospital immediately. The eye surgeon had told her that he could not rule out a globe rupture (i.e. bursting of the eye ball) from history and examination so far and that he needed me to be at another hospital in case he needed to do an emergency surgery.
This news came as a shock but I told myself to remain positive. I was given an eye shield to wear and Andrew was given directions to the Boulder Community Hospital where the opthalmologist will be meeting me.