Let the Patient Blink

In our experience, patients who have had angiograms elsewhere are often extremely apprehensive about repeating the test, saying the procedure was painful and traumatic. It is not unusual for a patient to say "The technician kept yelling at me to hold my eyes open." These patients usually find the test with us to be nowhere near as anxiety-provoking as their memory. Why? Because we let the patient blink.

Try this test: right now open your eyes wide and DON'T BLINK! Now try keeping your eyelids open for more than five or ten seconds at a time, and you will feel the burn as your cornea dries. If you manually hold the eyes open beyond this time, the blink reflex will become too strong to suppress. However, if you blink every few seconds, you can keep your eyes open wider than normal between blinks. Even under the discomfort of the constant illumination of the viewing bulb, most patients are able to keep their eyes open wide enough for photography if you let them blink as much as they feel necessary.

Patient blinking has no effect on your ability to focus, except to help it (a moist cornea is clearer than a dry one). Blinking has no effect upon the photography, as long as you do not actually take the picture during a blink. And blinking does have a tremendous positive effect upon patients: they are much more relaxed knowing they are in control of their own blink reflex. We will tell the patient: "You can blink all you want, just try to open wide between the blinks." This is successful in almost all cases, including mildly photophobic patients. Some patients who don't remember to blink will start squinting, making it appear that they need their lids held - they usually don't.

In the rare cases where you do need to hold the lids, remember to allow a blink as often as possible, every five seconds or so. Otherwise the patient will spend the entire session squeezing and squirming.

Letting the patient blink is an important part of patient management.


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