NOVEL NEXT WORLD Chapter 159
159. Vision Loss (1)
****
The Academy bakery was surprisingly decent. There’s butter on the morning bread—was it always like that? I wouldn’t know since I never buy it normally.
I only bought their moldy rice back when they served it.
But those days are long gone now.
“Is this not the moldy rice?”
“It’s new, don’t worry.”
Only then did Istina begin eating the morning bread, as if reassured. Like she’d really eat something that would kill her, seriously, come on.
“Istina, have outpatient or inpatient cases piled up while I was gone? It’s been a few days since I’ve been at the hospital, so they must’ve stacked up by now.”
Even though I wasn’t gone for long, it wouldn’t be strange if several patients came looking for me during my absence. No inpatients seemed to be around though.
“Oh, outpatient cases definitely piled up. As for inpatients, no one was scheduled to be admitted under Professor’s care.”
Thinking about how renowned professors at university hospitals often had waiting lists stretching months… maybe things weren’t as busy here after all.
Relatively speaking, that is.
Istina stretched.
“Still, Professor caused quite a fuss while you were away. You do know there’s a mountain of letters waiting for you, right?”
“They must’ve piled up.”
I sighed.
“We’ll start with clearing out the outpatient cases. You handle the letters. If any academic queries come up, think about what responses might work.”
“Yes, sir.”
Leaving Istina behind, I exited the research lab.
****
Time to get back to work.
With winter approaching, more people will likely visit the hospital. After all, heart disease tends to spike during seasonal changes, right?
I waited in the clinic.
A knock sounded from the clinic door.
“Come in.”
Today’s first patient arrived.
A female patient who looked about college age.
Her face was familiar… but who is she?
-Erzaabet Serulice.
-Wilson’s Disease.
Ah, that’s right—it was her.
It was Princess Erzabet from the House of Serulice whom I met before. After an intricate mystery unfolded, we discovered that Princess Erzabet was actually an adopted child suffering from Wilson’s Disease.
For anyone who doesn’t remember, Wilson’s Disease is when copper metabolism goes haywire and accumulates in the body, forming distinctive yellow rings around the eyes.
What I wanted to confirm was whether those golden rings around her pupils were still there—or if they’d disappeared. I hoped they were gone.
“Is this Miss Erzabet?”
Erzabet nodded in agreement.
“Are you feeling better?”
“Uh, yeah. I feel like I can think and move faster than before. And I don’t struggle getting up in the mornings anymore…”
How much medicine does she have left?
“As I mentioned last time, it’s best to avoid foods high in copper, such as nuts, seafood, and mushrooms. Have you avoided them?”
“Yes.”
“Let me take a look at your eyes.”
Erzabet stayed still as I gently lifted her eyelids. The distinctive ring around her pupil was gone, and there were no signs of copper accumulation in the whites of her eyes either. No jaundice either.
“You shouldn’t drink alcohol either.”
“Why not?”
“Your liver isn’t in good condition.”
“I see.”
Erzabet didn’t look too happy. It must be frustrating being young and having so many restrictions. I thought carefully about what to say next.
“There are a lot of things you can’t do, huh?”
“Yeah, lots of stuff I can’t do.”
“Well… I’m sorry. I wish there were better options, but it’s beyond my capabilities.”
“It’s not your fault, Professor.”
She sighed.
“I’ll give you another prescription. This time, I’ll also include zinc supplements—they help remove copper from the body.”
“Thank you.”
I glanced at her medical record again.
Thinking about it, Princess Erzabet wasn’t the only one suffering. If I recall correctly, all three children from the House of Serulice were sick.
Whether it was due to ergot poisoning or feigned illness remains a mystery.
“By the way, how’s your family doing?”
“My family? Why ask?”
Princess tilted her head in confusion.
“They were all sick when I visited last time. Just checking if they’ve improved at all.”
“It was all fake illnesses.”
I shook my head.
Healthy people don’t pretend to be sick. Whether it’s a kid faking stomach pain to skip school, someone with Munchausen syndrome self-harming, or the youngest sibling from the Serulice clan pretending to go crazy for attention…
Honestly, I still don’t understand the logic behind what the Serulice heirs were doing. I heard about it, but it made little sense.
“Everyone’s fine. No complaints about health issues. They didn’t even seem sick.”
Good to note down in the medical records.
Still, it’s fortunate the problem was resolved. It’s been weeks, and treatment has been going well.
“Oh, by the way, unrelated topic—I saw Professor’s name in the newspaper. Some bizarre article popped up, right? Is it true?”
If it’s something newsworthy, I could guess which story she meant. I scratched my head.
“You don’t need to believe everything you read in newspapers… but there’s probably some truth mixed in. Where there’s smoke, there’s fire.”
“Ah, I see.”
“Here’s your medication.”
“Thank you!”
Time to wrap up. I handed the glass bottle filled with pills to the princess. Bowing respectfully, Erzabet left the clinic.
And speaking of which…
Where are Erzabet’s biological relatives now? Given it’s a genetic condition, there’s a high chance they suffer from the same disease.
****
The second patient entered the clinic.
A male patient with a very grim expression. His head was slightly tilted to the left, and he kept glancing around excessively. Was it a tic?
Or…
“Can you see out of one eye?”
“How did you know?”
“It shows. Please sit down.”
Looking bewildered, the patient nodded and sat. In medicine, asymmetry is always worth paying close attention to.
Patients who can’t hear from one ear or can’t see out of one eye often exhibit compensatory behaviors—always.
Whether consciously or unconsciously.
Why might someone lose vision in one eye?
I pondered for a moment.
First, the most common cause of vision problems is post-traumatic brain injury. In such cases, sight usually returns within a few hours.
“What’s your name?”
“Ethan.”
“Mr. Ethan, how long has this been going on?”
“A day.”
Oh no. If it’s been over a day, there might already be tissue damage. Suppressing a sigh, I decided against alarming the patient further.
“Mr. Ethan, please close your left eye.”
“Yes.”
“How much can you see?”
“Uh… half? There’s a black spot…”
There are several possibilities. It could be diabetic macular degeneration, although a head injury seems unlikely but possible, or perhaps an arterial blockage.
I thought for a moment.
“Have you experienced any recent head injuries? Could it be related to that?”
“No. Although I fell yesterday because I couldn’t see properly, that happened after the vision loss started.”
Meaning we can rule out head trauma.
I thought harder.
“Has your urine output increased recently? Any foaming in the urine, or excessive thirst?”
“No.”
While diabetic retinopathy is the most probable cause if it’s not head trauma, diagnosing diabetes right now would be difficult.
Let’s assume for now there’s no diabetic polyuria. Diabetic retinopathy typically develops before diabetic polyuria sets in.
I thought harder.
“Have you noticed any blurriness recently?”
“No. It just suddenly happened one day.”
Diabetic retinopathy usually progresses gradually over months or years, but it can’t be entirely ruled out.
Retinal detachment, however, can occur suddenly even if caused by diabetes. Plenty of complications could arise.
“Let’s calm down for a moment.”
“But I am calm.”
“I’ll try calming myself. Let’s proceed assuming this is a solvable issue.”
Yes.
Don’t get too hung up on ophthalmology. Think step-by-step. First, let’s examine the retina.
“Open your eyes wide.”
I attempted to peer into the patient’s inner eye, but the retina wasn’t visible. Of course, if simply opening the eyes wider made it visible…
We’d usually use special equipment for fundus examination.
“Let’s do this.”
“Huh?”
“Let’s admit you to the hospital. We’ll thoroughly check if you have diabetes and identify any eye-related issues.”
“Is this something curable? Or will I have to live like this forever…?”
“I don’t know yet.”
The patient sighed.
Given the pupils are symmetrical and the pupillary reflex is normal, it seems unlikely to be a brain-related issue. A small mercy.
Let’s tackle the diabetes question first.
“Let’s start with a urine test.”
“Why keep bringing up urine?”
“We need to smell the urine.”
“Huh?”
The patient gave me a suspicious look. What am I supposed to do? Diagnosis requires urine tests. Should I just ignore it?