How often do you get a weird symptom and your first thought is, “Hm… Let me google this symptom.”
Many patients do it.
Whether or not you admit to it, we probably have all done it at some point in time! There’s no real shame in it, as long as you’re taking that information with a huge grain of salt. At this point, they just can’t seem to come up with that special thing that can mimic how a doctor actually thinks about a case.
Would it shock you to hear that online symptoms checkers are only correct for eye conditions 26% of the time? I don’t know about you, but if I saw a doctor who was only right 26% of the time, I’d probably be finding a new doctor pretty quickly!
But according to a recent publication in the Journal of the American Medical Association (JAMA), that’s how accurate they are for eye conditions.
Let me give you an example. It should be an easy one right? Let’s say a patient comes in and the only symptoms they’re noticing is redness, discomfort, and watering to their right eye. You type that in on WebMD and the top two result that pop up is allergies and “pink eye” (aka conjunctivitis).
Here’s the problem: one of those diagnosis could be correct based on the description I gave above. One of them is about 90% likely to be wrong, while the other technically can be considered “correct” because they used such a broad term, that it’s a decent catch all.
I could tell you allergies would most likely be the incorrect diagnosis based on symptoms. I can also tell you conjunctivitis could be correct because conjunctivitis is an umbrella term that has a lot of different types underneath it!
Just how many types of conjunctivitis are there? Well, here’s a few I can name off the top of my head: Basic Viral (like a cold virus) Allergic Bacterial (mild bacteria like staph) Herpetic Viral (either shingles or cold sores) Viral (from the adenovirus, much more severe and concerning) Bacterial (far more severe bacteria like pseudomonas) Toxic (could be chemicals or medications in the eyes) Contact Lens Overwear (there are several diagnosis that fall under this)
So just right there, we have about 8 diagnosis that fall under conjunctivitis. Those odds aren’t looking too good for WebMD to guess the right one.
But it gets even worse! Let’s add in some other diagnosis that can present with these symptoms, but aren’t conjunctivitis: Dry Eye Uveitis (also called iritis) Angle Closure Glaucoma Foreign Body (meaning you got something stuck in your eye) Episcleritis Scleritis (an extremely serious red eye condition) Subconjunctival Hemorrhage Corneal Ulcer Corneal or Conjunctival Abrasion Fungal Keratitis Acanthamoeba Keratitis Pingueculitis
I could go on and on…
So now we have minimum of 20 diagnosis (which if I wanted to expand it to 30, I very easily could). If we put those 20 up on a dart board and closed our eyes to see what we hit, you’d have a 5% chance of getting the right diagnosis. I like those odds even less. Then you try to throw into the equation what the recommended treatment is that these symptom checkers will try to give us.
When Dr. Soper and I took our national boards exams, we had to take them in three separate parts. The first part was basic knowledge we had learned in the first three years of school.
The second part was clinical and critical thinking. We would be given a picture with case history and had four options to pick the correct diagnosis. Here’s the fun part: the next 4-9 questions would all be based on our initial diagnosis! So if I picked the wrong diagnosis, then all my answers to subsequent questions are wrong too. That’s what can happen with these symptom checkers. They suggest an incorrect diagnosis 74% of the time (I would interject that it’s higher because they’re using the catch all term of conjunctivitis) and therefore will likely be recommending an incorrect treatment option.
While some of the conditions listed above are mild enough that if you weren’t treated, it might go away on its own. Sadly, many of them are serious enough that they can have permanent and lasting effects on your vision or even your life.
I’d like to think I’ve made my point though and will end it with my final thoughts. If your vision is your most important sense to you, would you rather trust Dr. Soper and I with your eye concerns? Or would you rather trust a computer that can’t examine you and is completely guessing based on vague symptoms?
I know which option I’d pick!
-Dr. Nick