The ProspectiveDoctor Podcast

MedSchoolCoach Case Series: Ophthalmology with Dr. Kelly

This episode kicks off the MedSchoolCoach case series. Here, we will listen in on discussions about cases that Dr. Renee Marinelli or other physicians have seen in their practice. Dr. James Kelly sits in as the first guest to discuss some recent cases that he has dealt with.

[1:09] 35-year-old man with double vision.

This had been happening for about five days and kept getting worse. The patient was bipolar and depressed, and took Depakote to treat this. However, the day he started seeing double, he had taken one extra pill. You can have a Depakote overdose even with normal labs, so Dr. Kelly had to speak with the patient’s psychiatrist to get his levels down.

[6:46] 55-year-old diabetic hypertensive man.

He was complaining of left-sided headaches for about three months, and now they were spreading to the right side of his head. Dr. Kelly noticed the nerve on the back of his left eye was edematous, which is always a warning sign. An MRI was ordered, and it showed that he had a subdural hematoma on that side of his head, so he was immediately sent to a neurosurgeon. The patient had fell a few months ago and hit his head but failed to tell anyone.

[10:50] Key takeaways.

Always be on alert for anything a little bit suspicious and never make any assumptions. The best way to recognize red flags is by seeing a lot of patients and talking to your colleagues. Even when you haven’t seen a ton of patients, keep in-tune with your own sense. If something doesn’t make sense, look for something else. Learn to ask the right questions and take your time when something doesn’t sound right.

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