Ophthalmology Anxieties

[mcctwist1]

It may be too early to think about this, but I have recently gained an interest in ophthalmology. However, I have this fear of irreversibly damaging someones eyesight, or even causing permanent blindness. My question is: how big are these risks in a typical ophthalmic procedure? I know any surgery on the eye is a delicate process, but I can imagine that if things go wrong...they can really go wrong. Are my reservations well placed, or am I being paranoid?

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[orbitsurgMD]

It may be too early to think about this, but I have recently gained an interest in ophthalmology. However, I have this fear of irreversibly damaging someones eyesight, or even causing permanent blindness. My question is: how big are these risks in a typical ophthalmic procedure? I know any surgery on the eye is a delicate process, but I can imagine that if things go wrong...they can really go wrong. Are my reservations well placed, or am I being paranoid?

If you really are pre-medical, it is way too early to be worrying about this. In fact, it sounds a little obcessive to have your level of concern.

The point of having good training is that you learn how to operate so that you have good outcomes and avoid bad ones. Also part of good training is learning things to avoid doing that get you into trouble, and also to learn to find signs that there might be trouble ahead before it becomes a problem.

 

[Ophtho24]

One of the best cataract surgeons I have ever seen told me before I ever started residency that you will not make it through your career without blinding somebody (at least one eye.) I think she is right when you think about it statistically. (I should probably do about 15000 cataracts during my career. Rate of endophthalmitis is about 1 in 1000) If that is all you think about it can be scary.
However, I am in my 3rd year and have only done 38 cataracts so far, but I have already taken 5 people from legal blindness to 20/25 or better. And I have blinded nobody. Life and surgery are not without risks. You can't expect that you can get the constant joy of taking people from blindness to awesome vision and never have to experience the horrid feeling of bad outcomes. Bad outcomes happen to everybody eventually and when you put this into perspective of all the people you have helped, I hope the risk benefit ratio becomes clear to you.
I will tell you it is very scary during your first few cataracts(and it should be), but it is also a really rewarding feeling to see these people postop. If you can't handle the few bad ones, then ophthalmology and medicine in general is probably not right for you.
Remember misdiagnoses in IM can lead to death, one wrong snip in gen surg can lead to death, all fields of medicine carry risk. Ophthalmology is not immune from this either.

 

[mcctwist1]

Hmmm that is interesting. Rereading my OP I think I came off too...forward? I should probably change the title of the thread. I know I am just a pre-med, but potentially becoming blind I think is one off the worst things that can happen to someone.

Ophtho24, that was a great post. I guess (well I assume) that it really is all about perspective. I guess the feeling of "curing the blind" is something that probably cant be beat. I appreciate the advice.

 

[MR1]

The worst thing that you can do to someone is kill them. Yes blinding someone does suck but they are still alive. The chance of blinding someone is rare though, like was said earlier with cataract surgery the risk is probably 1 in 1000 at the most. What happens more often is just a loss of vision but not blinding and that still sucks. You just have to get past it and realize it WILL happen to you. I tell all my cataract pt's the risks involved and make sure they understand them, I think this is a very important step. I guess pathologists, no they could misdiagnose a cancer. Maybe derm, no skin cancer and SJS. Everyone in medicine is a risk for missing something and really harming their pt's. It is why medicine sucks sometimes, but there is nothing like curing blindness. Trust me, just today even with the retrobulbar block in effect, my hand motion mature cataract right before I patched the eye said he could see me and was extremely happy.