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LETTER TO THE EDITOR |
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Year : 2018 | Volume
: 66
| Issue : 2 | Page : 339 |
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Time for introspection
Siddharth Agrawal, Rajat M Srivastava, Vinita Singh
Department of Ophthalmology, King George's Medical University, Lucknow, Uttar Pradesh, India
Date of Web Publication | 30-Jan-2018 |
Correspondence Address: Dr. Siddharth Agrawal Department of Ophthalmology, King George's Medical University, Lucknow, Uttar Pradesh India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_779_17
How to cite this article: Agrawal S, Srivastava RM, Singh V. Time for introspection. Indian J Ophthalmol 2018;66:339 |
Sir,
The well-written report by Chaurasia calls for introspection from our community.[1] The report highlights our nadir, concerning not so much the devastating complications of the procedure but the indication of the procedure itself.
A doctor and more so a surgeon has been placed in a privileged position in society, and episodes like this are responsible for the public gradually losing faith in us. Patients often have unreasonable expectations based on information received from the internet or advertisements from the industry, and it is unfortunate that instead of correcting them, we further misguide them for our gains. It is understandable that decisions are not often black and white but shades of gray, but if we remember the Hippocratic Oath and err on the side of “not doing harm” we would usually be correct.[2],[3]
This report is just the tip of the iceberg and many of us are guilty of letting finances dictate our decisions. However, one should be exceptionally cautious when dealing with a normal eye as in the report. Trying to improve on the creation of nature is to be foolish and is an action that is bound to be punished. We have seen the following when literature and logic both are against them: (a) refractive lens exchange being done for low myopia or incidental finding of trace cortical cataract, (b) Injudicious advice of multifocal intraocular lenses and intravitreal injections, (c) exaggeration of the benefits of femto-assisted cataract surgery.[4],[5],[6] Some of these may be debatable, but then, many similar conditions may be added.
Only way forward is to keep the interest of the patient central and all other issues secondary. It is also the only way in which we can restore our lost glory. When facing a difficult decision one should do a clear risk benefit analysis and ask oneself if one would advise the same management to a family member. The answer should be loud and clear. All the best.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | | |
1. | Chaurasia S. Devastating complication of cosmetic iris implants. Indian J Ophthalmol 2017;65:771-2. [ PUBMED] [Full text] |
2. | Franco G. Ethical analysis of the decision-making process in occupational health practice. Med Lav 2005;96:375-82. [ PUBMED] |
3. | Malecki M. 'Above all, do no harm': Safeguarding pluripotent stem cell therapy against iatrogenic tumorigenesis. Stem Cell Res Ther 2014;5:73. [ PUBMED] |
4. | Srinivasan B, Leung HY, Cao H, Liu S, Chen L, Fan AH, et al. Modern phacoemulsification and intraocular lens implantation (Refractive lens exchange) is safe and effective in treating high myopia. Asia Pac J Ophthalmol (Phila) 2016;5:438-44. |
5. | Alio JL, Plaza-Puche AB, Férnandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: An overview. Surv Ophthalmol 2017;62:611-34. |
6. | Moshirfar M, Churgin DS, Hsu M. Femtosecond laser-assisted cataract surgery: A current review. Middle East Afr J Ophthalmol 2011;18:285-91. [Full text] |
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