We would like to highlight the problems that patients with significant visual loss have in detecting clinically important signs. Two male patients aged 71 and 75 years, who were registered blind due to retinitis pigmentosa, were late presentations with bladder carcinoma. It was clear that these patients had haematuria for some time prior to presentation but were unable to detect this due to severe visual loss.
The purpose of this letter is to draw attention to the difficulty that patients with visual loss have in detecting signs that are easily apparent to patients without visual loss.
It is difficult to see how these problems can be avoided. One suggestion would be a protocol in place where patients who are placed on the Blind Register and their relatives are advised on their inability to detect clinical signs such as haematuria, malaena, and haemoptysis and therefore need regular assessment by a third party to detect such signs.
- © British Journal of General Practice, 2010.