SECOND OPINION | PATIENT STORIES | CORNEAL TRANSPLANT


[Paul] My name is Paul Orlando. I’ve been together with my partner, Randy
Kaplan, for nearly 35 years. For most of the time, I was wearing glasses. He remembers a time when I wasn’t wearing
glasses. But I started very early, like, the second
grade — went into the fourth grade, and was wearing my first set of bifocals. He witnessed my vision and it progressively
getting worse over a period of time, and even though I went to many ophthalmologists, they
were all saying, “Your vision is good,” but I was having troubles beyond just wearing
glasses. I said, “My night vision is bad,” so I gave
up night driving. I was having blurriness. It was difficult to work on the computer,
and I work on the computer all day. I have my own travel business, so it’s important
that I see well. About 10 years ago, after seeing many different
doctors, including retina specialists and ophthalmologists and doctors, they said, “You
have good vision.” I said, “I have a problem with vision. My vision is poor.” And I knew I had to find, you know, an answer
to what was going on with the vision. [Dr. Peter Salgo] Wow, Paul. That has got to be frustrating. [Paul] It was a lot of years of crazy. [Dr. Peter Salgo] Uh-huh. [Paul] Because I was told I had nearly perfect
vision, and I said, “Well, the reality is, I don’t,” and it took until I was referred
to the doctor here. [Dr. Peter Salgo] Well, let’s start from our
position of scratch, if you will. Lou, you’re a primary-care physician. Paul comes to see you, and I guess part of
this is, doctors aren’t taking him seriously. You see that? [Dr. Lou Papa] Oh, sure. I mean, there are patients that have lots
of complaints for lots of reasons that we may not necessarily be able to explain what
they’re having, and it feels like we’re dismissing what they’re having, what they’re imagining
what they’re having. But it begs the question from primary-care
point of view, looking for other reasons that he may be having visual problems. [Dr. Peter Salgo] So what would cross your
mind from a differential-diagnosis perspective? [Dr. Lou Papa] So, lots of times when I hear
that, things that I think about is that it may not necessarily be related to the eyeball
proper. It could be related to something metabolic. Diabetes can do that, thyroid conditions can
do that, and even some neurologic conditions can do that — so careful neurologic exam
and a biochemical profile just to rule it out. That will help the next doctor. [Dr. Peter Salgo] So you went to see a primary-care
doc, and what did he tell you, eventually, that he thought you had? [Paul] Ten years ago, they diagnosed me with
Fuchs’ syndrome.

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