To patch or not to patch

11/30/2009 at 5:21 AM 1 comment

I was trained to patch an eye if it had a scratch on the cornea. We would put some antibiotic ointment and patch it. The patient would try to keep the patch on as long as possible and voila’ in the morning the scratch would be gone.

Then came the researchers. They initially could not find any benefit from patching, then they found that it would heal better without patching. Furthermore, the antibiotic ointment seemed to slow healing.  Really? I thought. It heals completely overnight for pete’s sake, now much slowing could there be?

Ever the dutiful and responsible oldest son I changed my practice, but my observations went in complete conflict with the findings. People were less comfortable without the patch. They were more likely to do the very things that got them the scratch in the first place. and it was taking longer for them to heal.

What is a responsible physician to do?  I decided to give a few patients an option. Try it with and without the patch and let me know. People overwhelmingly preferred the patch . I have now gone back to patching them all the time and trying to get the patient to wear it as long as possible ( it’s hard, I have done it). So far success, they all heal by the next morning, patients are comfortable and happy. No eye infections to report ( K on W). Although, for any researchers out there, I still feel a tiny bit bad about it.

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Entry filed under: Doctor Musings. Tags: , .

coincidence? I don’t think so Put in Ear or drop in Eye- you choose

1 Comment Add your own

  • 1. mark  |  11/30/2009 at 6:11 AM

    interestingly (or not), i have the same problem when my computer asks me if i want to patch a particular application. if the application is a complete mess, the answer is simple – of course i will patch it. but what if it’s working more or less as it should do? do i patch it and risk complications in the future? this though keeps me awake all through the daytime.

    Reply

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