Ophthalmological jargon uses numerous concepts that are generally unknown by laymen and have to be explained to both hearing and deaf patients. Doctors vary in their ability to avoid unnecessary medical terms and to explain those terms that have to be used. Any medical term that is used slightly differently from its normal use should be clarified by the doctor; the interpreter cannot be responsible for the often subtle nuances in information related to visual phenomena or eye diseases.
Booklets like "Dictionary of Eye Terminology" cover ophthalmological terms well but the explanations given do not always give the information necessary for intelligent signing. For example, "hyperfluorescence" is correctly described as "increased fluorescence" seen in abnormal fluorescein angiography of the retina from abnormal blood vessels, leaking blood vessels, or increased fluorescein transmission". However, when the term is used, the doctor should describe the phenomenon of hyperfluorescence in that particular case, what it looks like in the angiogram and what it means. An interpreter cannot convey the information related to "hyperfluorescence" into sign language without that clarification. Mere finger spelling of the word is inadequate communication.
There are a number of other terms that are well described in the booklets on terminology, but they need further study before they can be used fluently. Refractive errors are hard to clarify if a person does not have background in the structure of the eye and optics. There is, for example, a common misunderstanding related to "hyperopia", farsightedness. People tend to think that hyperopia means clear vision at distance but blurred vision up close. It is therefore important to clarify that although the image falling on the retina of a hyperopic eye is blurred when the lens is in its resting position, the image becomes clear when accommodation is used. When distant objects are viewed, less accommodation is needed than when near objects are looked at. Young persons usually have such good accommodation that they can see clearly both at distance and near, even if they are hyperopic.
Similarly, when myopia is clarified, it is important to mention that the myopic eye sees clearly close up, although the image of distant objects is blurred.
Visual acuity values should be signed as they are written, although the "over" is not said. "Twenty-twenty" visual acuity is thus signed "twenty-slash-twenty".
The numerous acronyms used in a discussion between doctors cause a problem. They do not convey information to a hearing patient either but are more disturbing when used in the presence of a deaf patient who might think that the interpreter is not capable of interpreting in that situation. A group discussion is very difficult to interpret except if one of the doctors functions as a narrator of the discussion in plain English.
Condition, situation, and other place holders are common in medical jargon. Firstly, when they have to be translated, it is evident that they actually do not convey a definitive message. The meaning changes in different contexts. Therefore the interpreter cannot start interpretation before there is enough information for deciding the meaning of a "mush word". Since this causes delay, poorly defined words should be avoided.
"Immediate family" is one of the expressions seldom used in regular English but quite often discussed in medical settings. Whenever this or similar expressions are used and the meaning is even slightly unclear, the doctor should clarify what exactly is meant in this case. Genetic questions are often discussed during ophthalmological examinations and therefore genetic vocabulary and the ways of discussing family trees and modes of inheritance should also be discussed between doctors and interpreters early during the collaborative work.
In the text "Eyes and Vision" there is a list of questions that often occur during assessment of low vision. The content of these questions should be well known by every interpreter who is assigned to work in an ophthalmologist's office.
Questions1. Vision in twilight.
Do you see poorly in twilight and at night?
If you wait in the dark, do you start seeing better?
How long a time do you have to wait?
When you go into a dark room, does your field of vision become smaller?
There is often very little light on the buses and trains. Is it difficult to see there, on the buses and trains?
Is it difficult to go from a bright light to a place in shade?
When you go into a shop, do you have to stop at the door and wait for a while before you start to see in the shop?
2. Light sensitivity, dazzle.
3. Disturbances related to motion.
4. Contrast sensitivity. Can you see the curb?
6. Visual field.
7. Visual illusions.
8. History of the disease.
9. Visual aids.