I've asked our Eye Health Information Service what their thoughts were about this, and this was their reply:
"Gosh – not sure where to start!
"I think that there is a lot of miscommunication here between patient and practitioner. There are several things going on here and unfortunately dry eye is often underestimated as a cause of symptoms.
"Not all charts are the same. Charts don’t always have the same starting point, so the top of one chart may be 6/24 but that might be half way down another one. For example, my chart in the RNIB clinic at Judd Street starts at 6/60, but in private practice the default top line is 6/19. I guess what I’m saying is that they may think it was worse, but it might just have been a different starting point on the chart.
"I would suggest she speaks to her GP or high-street optometrist, and requests a referral to an ophthalmologist who specialises in dry eye or the external eye. It is important to note that dry eye is a chronic condition that will worsen when you are unwell, tired, aircon environment, central heating or dusty environments – so sometimes you need to increase the treatment and sometimes you go through better patches. In any case, once it’s better controlled you can see whether the other eye problems are also causing blur.
"It is extremely unusual to be allergic to sodium hyaluronate – usually allergies are to preservatives, not the active ingredients, so I would suggest that an external eye specialist could check this for them. There are plenty of alternatives in the old-style artificial tears, but they’re rarely prescribed because they don’t typically work so well.
"GPs sometimes don’t prescribe artificial tears now – it’s one of the medications that they advise patients that they have to buy over the counter.
"As it is so complex – might be worth just suggesting they call us so we can help her (0303 123 9999, Monday to Friday 8am to 8pm, and Saturday 9am to 1pm)! But if that’s not appropriate, then I'd suggest they request a referral to an external eye specialist, not a general ophthalmologist.
"Maybe a referral to an Eye Clinic Liaison Officer, if there’s one available at her eye clinic, would be useful, as it sounds like a communication issue as much as anything else. Also, she could really do with being referred to her local low vision service if she is struggling."