Getting patients to comply with medication instructions has always been a challenge, but “Mrs. Smith” had a different problem entirely. She came in to my group practice, South Jersey Eye Physicians, in Medford, N.J., about seven years ago for a standard, first-day postop visit following an uncomplicated cataract surgery performed on one of her eyes.

Mrs. Smith was petite, in her 60s and had been a delightful patient for the clinic; today, she was accompanied by a neighbor, “Ms. Jones,” who was in her 50s. Mrs. Smith had questions about her postoperative drops and complaints about a stinging feeling. Since that’s a pretty common issue with postcataract patients, I didn’t think much of it — until I saw the bottle she produced.

A DIFFERENT BREED OF MEDICINE

It looked nothing like the bottles we use at the clinic, which are squat, opaque and have finely printed labeling. The one Ms. Smith handed me looked like something pulled from a seventh-grade chemistry set. It was cylindrical, made of clear plastic and had a tattered, typed prescription label. The bottle was also covered with peeling tape and chew marks.

I knew it couldn’t have been something she received at our practice, but Ms. Smith was insistent that she had been given it at the ASC yesterday. Then I read the name of the “patient” on the bottle, and it all fell into place.

“Who’s Fido?” I inquired. Mrs. Smith’s countenance completely changed. “Oh my goodness, that’s my dog! Oh my!”

“Did you really use these drops?” I asked. “Yes, three times,” she responded. At this revelation, Ms. Jones, who sat on a bench nearby, just shook her head and looked entirely unsurprised.

Yes, the medication was for Mrs. Smith’s dog’s dry eyes — apart from the initial stinging, though, she suffered no ill effects from its use.

DRIVING MRS. SMITH

With that mystery solved, Mrs. Smith began to tell me how pleased she was with her new vision. Before her surgery, her sight was limited to light perception. That morning, though, she walked to Ms. Jones’ house for the first time, which she had not done before for fear of falling.

One other thing in her records puzzled me, though. “Mrs. Smith, it says you drove yourself to your appointment a few weeks ago.” I asked. “Is that right?”

“Yes, my dog helps me drive, but if I walked I could have hurt myself.” It turns out Fido barked at traffic lights, telling her when to stop.

To the best of my knowledge, Mrs. Smith never had another problem with her medication. I checked in with a fellow surgeon at the practice who operated on Mrs. Smith’s second eye at a later date. He said she was a charming patient and left happy as a clam. OM

Miriam R. Brown, MD, practices comprehensive ophthalmology at the Medford, N.J., Moorestown, N.J., and Columbus, N.J., offices of South Jersey Eye Physicians.