Christopher J. Borgman, OD, FAAO

Band optic atrophy is described as a horizontal band of optic disc pallor, often associated with a contralateral optic tract lesion and bilateral hemianopic visual field defects.

A 40-year-old African-American male patient presented to our clinic for his first eye exam with a complaint of new onset horizontal diplopia for several days. He reported it was worse at distance and when looking to his left. He denied trauma, headache, redness or vision changes in either eye.

A 48-year old white female presented for her annual eye exam through our primary care service. She was severely disabled (both mentally and physically), which left her confined to a wheelchair and completely nonverbal. She lived in a group home where a caretaker could tend to her needs around the clock.

A 20-year-old African American woman presented with a chief complaint of a moderately red, watery right eye with mucopurulent debris that started 4 days earlier. The patient denied recent fever, upper respiratory infection or sore throat. She reported being postpartum for approximately 6 weeks at this visit. She had a full-term vaginal birth without complications and was currently breastfeeding.

A 26-year-old Caucasian female presented to our clinic for evaluation with one of our colleagues. Her chief complaint at that exam was a recent onset of near vision blur only, which she felt was slightly worse in the right eye for several weeks. She described the blur as being constant with no fluctuations. In addition, she also stated she was not experiencing any headaches or double vision.

A 69-year-old African-American female presented for a regularly scheduled annual eye exam with the chief complaint of a droopy left upper eyelid of 8 years duration. She also reported diplopia upon manually lifting her left eyelid.

A 44-year-old African-American female presented to our emergency eye clinic with a chief complaint of blurry vision equal in both eyes, at both distance and near. She reported that she had been hit in her left eye with a coat hanger 5 days previously, which was when she first noticed the vision suddenly becoming blurry along with flashes and floaters greater in the left eye than the right.

As knowledge progresses in eye care, we sometimes find that commonly used medications are useful for off-label treatment.

In cases where patients have no insurance or have limited prescription coverage, a management plan can be challenging.

Throughout my residency and my several years in private practice it became obvious to me that most of my colleagues do their billing and coding primarily out of habit rather than according to the Current Procedural Terminology guidelines and the 1997 Evaluation and Management guidelines.