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Annual Eye Examination
Dec 25, 2005

Yesterday I visited an optometrist who was referred to me by my primary care physician. I left the office feeling a bit deflated and did not immediately know why. After reflection I realized I was reacting negatively to a comment from this physician.

When asked the purpose for my visit I replied that I was HIV positive and needed a vision checkup for CMV etc. During the checkup the Doctor asked me the values of my last TCell count and viral load. After informing her that my CD4s were 270 and load 2,500 she commented that that was very low. I dont know if it was her tone or demeanor, or simply my own sensitivity about this comment, but I immediately offered up an excuse about changing meds and my count actually being on the rise. As if to add insult to injury she followed up with an inquiry as to how long I had been HIV positive. Before this visit I actually felt very positive about my recent counts, and even though I constantly remind myself they are just numbers I always have to make an effort to avoid looking at these statistics from a negative viewpoint. I got the sense that this question was posed more out of morbid curiosity motivation and not really appropriate and necessary for the intended procedure.

I feel better now, and a bit silly for letting one comment temporarily take the wind out of my sail. Anyway I suppose you get the gist of what Im saying. Here is my question, Did this Doctor really need to know this information? and Would the exam have been different say if my TCell were 500?

~Thank You

Response from Dr. Pierone

Well, optometrists know eyes, but most probably don't really know the ranges of CD4 cells and viral loads and what they signify. A CD4 count of 270 is certainly not low and the chance of HIV-related eye complications at this level is negligible.

It is important for an eye doctor to know the CD4 count, viral load, and clinical status of the patient. But it may be difficult to read some health care workers and where they are coming from. Sometimes it is not the actual question, but the tone of voice, or nonverbal cues that can produce discomfort. As a general rule, one should avoid clinicians that when you leave the interaction feeling badly.

Thanks for posting and best of luck to you!



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