In the Blink of an Eye

Dan has been a patient at the clinic for a little over a year. He takes a few medications and sees a provider rarely. He applied for the Healthy Michigan Plan (Medicaid expansion), but was denied. He scheduled an appointment with me to apply for insurance through the Marketplace in December. The day before our appointment, I received a call from his significant other cancelling the appointment because he had just had surgery at the University of Michigan.

He had suffered from a detached retina. Retinal detachment is an emergency situation in which vision can be permanently lost.

Retinal detachment describes an emergency situation in which a critical layer of tissue (the retina) at the back of the eye pulls away from the layer of blood vessels that provides it with oxygen and nourishment.

Retinal detachment leaves the retinal cells lacking oxygen. The longer retinal detachment goes untreated, the greater the risk of permanent vision loss in the affected eye.

Retinal detachment itself is painless, but retinal detachment warning signs and symptoms almost always appear before it occurs or has advanced. Retinal detachment symptoms may include:

• The sudden appearance of many floaters — small bits of debris in the field of vision that look like spots, hairs or strings and seem to float before the eyes
• Sudden flashes of light in the affected eye
• A shadow or curtain over a portion of the visual field that develops as the detachment progresses

 

Retinal detachment can occur as a result of:

• Shrinkage or contraction of the vitreous— the gel-like material that fills the inside of the eye. This can create tugging on the retina and a retinal tear, leading to a retinal detachment.
• Injury
• Advanced diabetes
• An inflammatory eye disorder

 

Dan does not know what caused his retinal detachment. But, he was lucky that it was recognized and he was sent to the proper place for treatment. He won’t lose his vision. And his care was provided by the University of Michigan’s Charity Care.

Once he recovered, he came in to apply for healthcare coverage. He is lucky, because before the implementation of the Affordable Care Act, he would not have been able to get insurance because of his pre-existing condition: the retinal detachment. Now he can get coverage and it will cover any medical care that still may be needed for the detached retina. He is a lucky man.