Are ophthalmologists thinking "outside the eyeball"?

Perhaps not, if my recent experience is any indication.

A family member was suffering from eye pain whenever she moved her eyeball, so I took her to the Wilmer Eye Institute. After Dr. B examined her, the gist of what he told me was something like this:
Dr. B: Her eyes are fine. I don't see anything wrong.
Me: So if the pain comes back, should she see a doctor or can we safely ignore it?
Dr. B: I can't say that. It depends.
Me: What do you think caused it?
Dr. B: I have no idea.
Me: If a thousand patients like her were to come in with these symptoms, what are the odds that it's a serious problem that needs treatment?
Dr. B: I haven't seen any cases like this--ever--where there was a serious problem.
Dr. B's answers didn't ring true. Like so many other doctors in my experience, he was unwilling to give any type of probabilistic estimate. [Why is that, I wonder? - Ed.] I asked some more questions but eventually gave up trying to elicit anything of use from him.

For the record, we later discovered that my family member had Lyme disease, which apparently can cause eye pain. It was serious, and she did need treatment.

My guess is that Dr. B is a fine doctor within his specialty, recognizing and treating diseases of the eye. But in our case it seems that he was thinking only inside the eyeball. When the symptom was in the eye and the cause was elsewhere, he essentially was implying to us that "It's not my problem". And he didn't seem to be in a mood to think about or discuss what the real problem might be.

Somehow I expected more than that.

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