Reverse Translation

For health care providers working with a low English-proficient patient population, emphasis is oftentimes focused on providing translation services only in one direction: from our source language, English, into the goal target language of the patient.  As a clinical ophthalmologist serving a community of Spanish-speaking patients, I have provided this to my patients: written translation of English into Spanish of various forms of office documentation, including patient referral information, correspondence letters, educational pamphlets, surgical consent forms, etc.

However, I discovered over the years during my clinical encounters that there can be just as much of a need for translation in the opposite direction, from Spanish to English, in order to provide proper continuity of care. Many of these patients maintain close ties with extended family and friends in their home countries, and travel to those countries often as they possibly can. Therefore, many of them continue to receive care from their personal doctors serving them back home.

In order to properly coordinate care for these patients, particularly for chronic conditions, such as glaucoma care or diabetic retinopathy monitoring, I provide a summary of exam findings for my patients to take to their doctor. They, in turn, return with reports from their physician written to me, often written in their native language. Below I have copied one such report, which was furnished from the patient’s ophthalmologist in her home country. It is an Optical Coherence Tomography (OCT) scan of her optic nerves and retinal nerve fiber layer, routinely performed by ophthalmologists to monitor for glaucoma progression. After the original letter, you will find my translation into English. I then touch on some keys points in the letter.**

**The patient and doctor’s name have been removed for privacy reasons.

Original letter:

Informe de OCT – NIDEK

Tomografía de Coherencia Óptica

Fecha: 09 Febrero del 2017

Paciente:

Referido por: Dra. --

Resultados:

Utilizando el RNFL and ONH: Optic Disc Map 256 x 256 y

realizando un análisis del promedio del grosor de la capa de fibras

nerviosas, encontramos valores en OD 101 micras y OS 93 micras. Presenta

una curva comparativa simétrica 87%. En cuanto al estudio de la cabeza del

nervio óptico, resaltamos que se aprecian un radio promedio excavaciones

en OD 0.46 y OS 0.54, con una relación C/D vertical en OD 0.44 y OS 0.58,

con un disco total de 2.18 mm² y 2.10 mm² , respectivamente. El TSNIT

muestra alteración en cuadrantes temporales AO.

Realizamos análisis de células ganglionares las cuales se encuentran

disminuidas en AO.

Estos resultados tomográficos muestran un conteo de fibras nerviosas

bajo con alteración en las células ganglionares, por lo que este estudio

podría considerarse sospechoso de Neuropatía Glaucomatosa Inicial,

recomendamos realizar Gonioscopía, correlacionar con la paquimetría y

repetir estudio diagnóstico dentro de 1 año para control y seguimiento.

Gracias por su gentil referimiento,

Dra. --

Cirujano Oftalmóloga

                                                                        *

OCT-NIDEK report

Optical Coherence Tomography

Date: February 9, 2017

Patient:

Referred by: Dr. --

Results:

Using the retinal nerve fiber layer and optic nerve head Optic Disc Map 256x256 and performing an analysis of the average thickness of the nerve fiber layer, we found the following values: 101 microns in the OD and 93 microns in the OS.  This presents a symmetric comparison curve of 87%.  In relation to the optic nerve head study, we note that we can appreciate average optic nerve cupping of 0.46 OD and 0.54 OS, with a vertical C/D ratio of 0.44 OD and 0.58 OS, with a total disc area measuring 2.18mm² and 2.10mm², respectively.  The temporal-superior-nasal-inferior-temporal (TSNIT) analysis shows an alteration in the temporal quadrants of both eyes (OU).

We performed an analysis of the ganglion cells which were found to be diminished in both eyes.

These tomographic results show a decreased nerve fiber layer count with alterations in the ganglion cell layer, and therefore should be considered suspect for Early Glaucomatous Neuropathy, we recommend doing a gonioscopy, to correlate with the pachymetry and repeat of this diagnostic study within one year for maintenance and follow-up.

Thank you for your kind referral,

Dr. --

Ophthalmic surgeon

                                                                        *

During the course of my translating this article from its original Spanish into English, I noticed that some of the ophthalmic abbreviations that we ophthalmologists and optometrists use here in the US  are the same as those used by eye care specialists in Spanish-speaking countries. Others, however, are different. Therefore, I did some research and found a very helpful website online: Vistaláser Oftalmología, which happens to be the website for a group of practicing ophthalmologists in Málaga, Marbella and Granada, Spain. The address is as follows:  https://www.vista-laser.com/abreviaturas-optometria-oftalmologia/

The page is broken into the following groups:

Abreviaturas médicas sobre la salud ocular, or Medical Abbreviations regarding Ocular Health

Abreviaturas de oftalmología, or Ophthalmology Abbreviations

Abreviaciones de óptica-optometría, or Optical-Optometry Abbreviations

Abreviaciones médicas habituales, or Common Medical Abbreviations

Sometimes, doctors in Spanish-speaking countries will use some of the same abbreviations we doctors in the US are familiar with because they both come from the Latin language. An example of this is the abbreviation:

OU, Latin for oculus uterque, and what we know as both eyes

OS, Latin for oculus sinister, and what we know as left eye

OD, Latin for oculus dexter, and what we know as right eye

In this particular report, what I found interesting was that the author used the familiar OD and OS, but then used the abbreviation:  AO, which I had never seen before.

If you peruse the list of abbreviations on the VistaLáser Oftalmología website, you will find that AO is the Spanish way of saying OU, or both eyes:

AO, from Ambos Ojos=both eyes.

To summarize, English and Spanish-speaking doctors will likely be able to use several ocular abbreviations interchangeably, due to the common use of Latin in medicine. However, there will also be special means of referring to a disease state or an ocular structure that is unique to the language of origin. As is the case with any translation, continue to be a sleuth – try to find parallel texts or resources such as the VistaLáser Oftalmología web page to help explain and clarify any uncertainties. In this way, your translated text will reflect the intent and meaning of the original as closely as possible.

References

Abreviaturas en optometría y oftalmología. Retrieved October 24, 2017 from  https://www.vista-laser.com/abreviaturas-optometria-oftalmologia/ 

NYC mural by Lunar New Year, October 2017