do you think this optician was being unreasonable?

[parakeet]

I had an emergency appointment with an optician yesterday as I woke up with a kind of small raised blob on the conjunctiva of my eye. It feels irritating but not painful. She told me it was a pin vacuole (I wrote it down) and I had it for good now and there was nothing that could be done.

Firstly, I cannot find this thing on 'tinternet, so I'm guessing I wrote it down wrongly - can anyone knowledgeable make a guess at what she meant so I can look it up and find out more? Secondly if you know what it is, is there really nothing that can be done? I can feel it all the time.

Thirdly, she also said I had papillae on my lower eyelid, which could be caused by my (daily disposable) contact lenses. I have to stop wearing them for a week and treat with sodium chromoglycate eyedrops. I've looked this up and it looks like if the problem doesn't go away I may have to switch to monthly lenses or glasses. But I was concerned because she said the eyedrops were an antibiotic (several times), and they are actually an anti-inflammatory.

I'm the type of person who, if I go to the doctors, I need to understand what's going on. This optician gave me a very garbled explanation of why the papillae form, and how the drug works, and I've lost all faith in her. Has anyone had experience of this with contact lenses? Sorry to post in AIBU, but I'm getting rather worried about my eyes, and feel a bit sad about the prospect of switching to glasses. Yes, I'm vain, I know. Thanks for any replies.

it wasn't this was it?

Hi - Is is possible for you to get a second opinion? I find it hard to believe that you haven't been referred for a check with an opthalmologist at the hospital. I would make an appointment with either your GP or a different optician's.

was it this-

en.wikipedia.org/wiki/Pinguecula

Try looking on here & see if you can find it
www.allaboutvision.com/conditions/

en.wikipedia.org/wiki/Pinguecula

sorry link

Sodium cromoglycate is a mast cell stabiliser so it stops the cells that produce the histamine that cause the allergy working. Papillae are small bumps on the inner surface of the lid formed when you are having an allergic reaction. Were they are the inner surface of your top lid as well (normally flipped over to look at a contact lens check)? Do you have hayfever or other allergies? Monthly contact lenses won't be better than dailies. It is unlikely you will have to go to glasses unless they are very bad (unusual).

A vacuole is basically a sac - not heard of a pin vacuole - sounds like a very tiny vacuole though.Fluid cysts or pingecula (yellow blobs due to ageing) on the conjunctiva are not uncommon though.
Are they reviewing you again in a week before you start wearing your contact lenses again? If so, I'd ask for a further explanation and ask her to write it down for you as well.

I was going to say pingueculum - small yellow lump adjacent to the iris at the 3 or 9 o?clock positions. They may become inflamed.

sometimes growth can be reduced by steroids, but commonly no intervention is needed.

Not sure about the drops, I would be concerned to be told they were antibiotics, but were anti inflammatory.... second opinion required on both counts, I think.

The optician describing something as an antibiotic when it isn't would seriously undermine my trust in her capability and general on-the-ball-ness, and prevent me trusting her on the "pin vacuole" issue too. I would definitely go to a second optician about it.

Yes definately sounds like a pingecula looking at it,with the sound being fairly similar to pinvacuole. Ageing in combination with general UV light exposure cause them so not alot you can do I'm afraid. They are really, really common and not caused by contact lens wear. If the eye is a bit irritated by dryness or allergy they will get a bit redder and may feel a little irritable. It does not need referral and the hospital eye clinic would be fhmm to see it. Ring the opticians tomorrow and ask to speak to the optician. Ask if it is a pingecula and how the drops work - if she says antibiotic again then ask to see another optician in the practice for your review.

- no good with smileys.

Thanks very much everyone. I think the thing the blob looks most like is the pingueculum - except it is not yellow, it is more like pale pink. Anyway, you have reassured me I'm not being unreasonable to want a second opinion rather than just trusting her it is benign. I think I will go to my GP as a first step.

To answer the questions, no, the papillae are not on my upper lid, just the lower (she did flip the upper lid over, to check). And yes, the plan is to return after a week's treatment with the "antibiotic"...From the web it looks like it could be the first sign of giant papillary conjunctivitis, which some sites do seem to recommend switching to monthly lenses for. At next week's visit I will definitely ask her for the names of important terms and ask for the spelling. Thanks again all.

Hey flying, I have already had it out with her about the antibiotic error - it was a bit embarrassing. She recommended the eye drops by writing down the brand name - Optichrom. I handed the note to the pharmacist at Boots and she said they couldn't get that any more but here were some eye drops that had the same ingredient, sodium chromoglycate, an anti-histamine. I said no, no, I was told I need an antibiotic.

Long story short, I dashed back into the opticians saying the silly people in Boots are trying to give me sodium chromoglycate, what should I do? The optician rather embarrassedly said yes, that's the right thing. I said: You told me it was an antibiotic. She said, and I quote: "Well...antibiotic, anti-allergic..." and shrugged. Hence: losing faith.

I don't know what sites recommend switching to monthly lenses, this isn't the current advice from dailies - just shows you have to be a liitle careful on the web.
Giant papillary conjunctivitis would normally present on the upper lid before the bottom and are just bigger papillae - same treatment though.

I'm afraid the GP can't do alot except reassure you unless they see infection,as they won't have the slit lamp microscope to look at it and will only be able to look with the naked eye. They will probably just say use the drops and see the optician again next week.
Follicles are lumps that can be confused sometimes with papillae but are viral in origin.
I would ring the opticians and ask to see another optician tomorrow just to clarify as you have questions which were not answered at the emergency consultation.

Yes, she should definately know sodium cromglycate is not an antibiotic. Really basic stuff and not at all the same thing. Ask to see another optician in the practice.

Yes, but surely a GP could refer me to an NHS opthalmologist?

Oh god, I dunno. I guess I'll wait til I've used these drops for the week, but make sure I see a different optician when I go back and get them to write everything down.

I doubt you would get referred to an ophthalmologist for a pingecula and papillae. If you did it would be non emergency - so up to 12 weeks wait and probably only after you had tried some treatment 1st.

I'd do what you proposed in your last sentence. If the irritation or redness gets worse or you get any pain then it does need an emergency check.

DH is an optician and I've just read him your post - he said 'bear with me' and disappeared into the study, will report back later!

He said it's probably caused by dryness and possible over wearing of lenses- he'd gone to get a picture from his college text books to show me. He wanted to know how old you were and whether or not of you wore soft lenses. Apparently hormonal changes can wreck your tear film and this sort of irritation is more common with hard lenses. He doesn't think it's anything drastic, try the eye drops and like flyingcarpet says, if it gets worse go back.

Just reread post with mention of college books and wanted you to know that despite how I've just made it sound do has 20 odd years of experience-the books are v. old and dusty now!

Hi therose. Thank you for enlisting your husband to help. I wear soft (daily disposable) lenses and I am 41, no signs of menopause yet. Can I just ask, though, was he referring to the pingecula or the papillae when he said it was probably caused by dryness and overwearing of lenses?

My plan is to return after one week, as instructed, but see a different optician. One who knows what an antibiotic is. Many thanks.