A former business executive who is smoking and drinking excessively presents to the emergency department with visual loss and poor nutritional status. Despite the entreaties of family and friends, he repeatedly refused support and medical management.
As a GP also working shifts in the local hospital’s emergency department, you sometimes find people you know socially ask to be looked after by you when they have to attend the department.
While on duty one day in the emergency department, you get a phone call from an ophthalmologist regarding a patient who asked him to call you rather than the patient’s own GP.
The patient is a 51-year-old former business executive, whom you know and until a few years ago saw regularly on a social basis. He had been referred to the ophthalmologist by the optometrist he had consulted for new glasses. The ophthalmologist expresses concern about the vision and general health of the man, who he is worried may have toxic optic neuropathy as well as possibly something more serious, such as a cancer.