One missed diagnosis and BAM, one of my good friends and colleagues is partially blind in one eye.

4 weeks of intermittent one sided headaches that aren't relieved by the usual migraine medication. History of cluster headaches but never with this odd "Vaseline vision" in one eye.

Saw them in the cafeteria - mid fixed and dilated pupil. Took them to emerg to be seen. Expedited their entry but couldn't stay with them because I had clinic. Found out later they'd discharged with meds and a diagnosis of cluster headache.

The doc didn't look at the eye - dismissed it.

2 days later a 6 am. phonecall - "I think I've got acute angle closure glaucoma" - a sleepy drive to emerg. Thank god for a smart medical professional self-diagnosing on google.

We are all relieved when we miss and it makes no difference - but how do we deal with the one we missed that resulted in a bad outcome? I am as guilty as they are - I saw the pupil in the cafeteria and I tested the reactivity and misdiagnosed it myself - all those ophtho lectures in med school didn't sink in. I will never miss a case of this. I will never miss a case of the thing I missed a month ago - but what about all those other things I've never seen?

I'm struggling with the responsibility that comes with my profession.