Don't laugh at me.

Sasha

Sasha

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I need the word to describe and chart the fact the patient has wonky eyes that face different directions and I don't foresee "patient has wonky eyes with reactive pupils" going over well with my supervisor.
 
Lazy eyes I believe. not really sure what a more "medical" term for it would be
 
Could be strabismus. (Pointing inward is esotropia, outward is exotropia.)
 
Sasha said:
I need the word to describe and chart the fact the patient has wonky eyes that face different directions and I don't foresee "patient has wonky eyes with reactive pupils" going over well with my supervisor.
Click to expand...

Lol
 
Extropia or binocular double vision.
 
Dysconjugate gaze.
 
Wouldn't double vision be more of a subjective sign that the patient would report to you?

Kind of related; I got "talked to" by an MICN with a lazy eye for acting in the best interest of a patient rather than blindly following protocol.

At the end of the conversation he asked if we were "seeing eye to eye." I wonder how many times a day he tries to use that phrase...
 
Just curious, but why is that relevant to your chart?

Can't you just say pupils were PEARL since the direction their eyes face probably wasn't the reason 911 was called?
 
Dysconjunctate: they don't move the same direction or one moves and the other doesn't. One can move in a different direction entirely (yikes). (Think Imogene Coca).

Nothing%2BLasts%2BForever%2B249.jpg

Or a chameleon
chameleon-eyes.jpg


This can be due to mechanical injury to the ocular muscles and nerves as well as potential CNS lesions.

Strabismus: the eyes don't point at the same target, but they both move in the same manner. (think Marty Feldman)
1756_1012611579.jpg


Walleye: old term for strabismus.

Lazy eye: can refer to ptosis (droopy lid), or amblyopia, which is not visible per se but the brain's ignoring the input from one eye (either from strabismus/disconjuctate gaze, or wearing hair or a patch etc over one eye, or just not using it for whatever reason, could be a CNS lesion.
D607E2E1E078-7.jpg


NOTE: you will find pictures of Mr Feldman with apparently conjugate eyes. You will see videos of healthy people with apparent independent eye movement. These are usually due to looking at the subject from an angle where one eyes is "trapped" (can't move any further), then the head and other eye turned so that both eyes then point coaxially, or traps one eye in one axis (say, vertically) but allows lateral monvement, then both eyes are moved in the oblique so one moves obliquely but the other only moves laterally.
In other words, have them face straight ahead and you look straight at them.
 
sasha said:
i need the word to describe and chart the fact the patient has wonky eyes that face different directions and i don't foresee "patient has wonky eyes with reactive pupils" going over well with my supervisor.
Click to expand...

hahaahahahahahahahaha!
 
I like "wonky eyes" but I guess dysconjugate gaze is the best professional definition for it in a PCR.
 
Maine iac said:
Just curious, but why is that relevant to your chart?

Can't you just say pupils were PEARL since the direction their eyes face probably wasn't the reason 911 was called?
Click to expand...

Because I like to be very complete in my charts and document things that may help me remember the patient later on down the road.

For eyes our check boxes are:
WNL
Dilated
Constricted
Unequal

They're definitely not normal to be wonky.

Plus I like using big words that frustrate the billing department as much as they like kicking back my charts for something ridiculous.
 
Ps thanks mycrofft. You were super helpful.

And everyone else too.
 
NVRob said:
I like "wonky eyes" but I guess dysconjugate gaze is the best professional definition for it in a PCR.
Click to expand...

I like it too.

But....

The billing departments patience with me is wearing thin. Recently I've accidently written that a patient is "confuzzled", described a brace as one that braces the knee and described a patients multiple fx'd arm as bendy in the wrong directions.

I feel wonky eyes would push the envelope.
 
Just call him cockeyed!!!! LOL
 
Sasha; don't know about the rest but thank you very much needed a good laugh today
 
That's why MD's don't like multiple choice charting.

Use the "other" or "Misc" slot a lot, do we?

Dysconjugate sounds impressive. If this is frequent, why not ask Billing what the phrase they are expecting is? Likelihood is they are trying to use their program to meet the criteria for an expectant payment plan which says "you will be paid $X for the following: " and expects the same repeated wording to describe lives many ailments.

Thanks for whomever developed the Diagnostic Related Groups (DRG's) in the late Seventies. A lot.<_<
 
Whenever the boxes don't exactly describe what I want I ignore them (unless they're required fields, which is obnoxious) and use the narrative. And when I don't have a great ten-dollar word for what I see, I just describe it in dumb people language, with which I am fluent.
 
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