Tips for Healthy Eyes in 2013

Well, we’re not all dead, so it looks like we’ll have to endure another year.  2012 gave us many things to remember, although I can’t really remember any of them right now.  With that in mind, let’s look forward to 2013 and the best ways to keep your eyes healthy in the year to come.

1.  Vitamins A, C, and E (the antioxidants) are good for your eyes.  Vitamin Q, however, is not.  NEVER take vitamin Q.

2.  Despite popular knowledge, wearing someone else’s glasses will not cause your vision to deteriorate.  Although wearing them might turn you into that person.

3.  Avoid staring into the sun.  This can cause damage to the eye known as solar maculopathy.  That being said, this damage generally only occurs after prolonged viewing of the sun; if you just want to glance at it, that’s fine.  The sun is pretty.

4.  Flashes of light or an increase in floaters in your vision may signal a retinal detachment, which requires prompt detection and treatment.  These symptoms may also be caused by attending a rave; if you hear a thumping bass beat, you probably don’t have a retinal detachment.

5.  Double vision, or diplopia, is a bad thing.  If ever you should see double, get yourself to an eye doctor immediately.  You may have an aneurysm.  You may also have a drink in your hand; if you have a drink in your hand, the diplopia is probably not as urgent, although you should get to an eye doctor soon anyway, just in case.  Put the drink down first though.

6.  Call your mother; she wants to hear from you.  This has nothing to do with eyes, but it’s just good advice in general.

7.  When your optometrist offers to dilate your pupils, go along with it.  Yes, your near vision will be blown to smithereens for a couple hours.  Yes, the sun will seem so bright that it’s as if the star around which our little planet revolves has a personal vendetta against you.  Yes, your eyes will look as though you just indulged in an illicit mind-altering substance.  However, with dilation, your optometrist can detect not only ocular abnormalities, but many, many other systemic diseases that may have as yet gone undiagnosed by your primary care physician.

Even Mario hates being dilated.

Even Mario hates being dilated.

8.  If your eyes burn, they’re probably dry – use artificial tears.  If your eyes water, they’re probably dry – use artificial tears.  If your eyes feel “tired,” they’re probably dry – use artificial tears.  If artificial tears, they’re probably artificial tears, use artificial tears.

9.  Take your contact lenses out of your eyes.  Unless you’re not wearing contact lenses.  Overwearing your contact lenses can lead to the following:  vision-threatening eye infections, corneal neovascularization, giant papillary conjunctivitis, corneal edema, and jelly bumps.  Yes, jelly bumps.  You may ask, “What are jelly bumps?”  Wear your contacts for too long, and you’ll find out.

10.  If you’re staring at a computer screen right now, take a break!  Every 20 minutes look away from the screen for 20 seconds.  Computer vision syndrome exists and is becoming an epidemic; you can avoid it entirely by just looking away. Go ahead, look away.  You’re not looking away.

Look away.

Do it.

You’re not going to miss anything.

I promise.

Really, at this point I’m just trying to be facetious.

Have you looked away yet?

So those are 10 tips for protecting your eyes for the new year.  2013 looks like it’s shaping up to be a good one, and I think we owe it to ourselves to make it count since we survived 12/21/12.  Be happy, be safe, and I’ll see you at the party after we all survive 13/21/13.

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Detached

SETTING – AUTOMOBILE INTERIOR

PATIENT VOICEOVER

So now I’m lying here on the backseat of my sister’s car, trying to stay motionless as we speed north on the highway.  I was told to lie on my right side.  It’s an hour-long drive and I can’t even look out the window.  This saddens me more than anything because soon I might never be able to look out a window ever again.

It started with a flash.  Kind of like the times when Sam and I were little and Mom would pose us in front of whatever backdrop coincided with that particular time of year: us in front of the beach, us in front of the Christmas tree, us holding hot dogs in one hand and American flags in the other, Samantha dressed as a kitten and myself as Batman with a plastic pale full of candy.

Flash, flash, flash went Mom’s camera.

The afterimage was seared into my central vision.  Every time I blinked I’d see it again, refreshed.  A big jagged-outlined blankness of indeterminate color.  Eventually it would fade and things would be normal again.

The difference is that now it’s not fading.  And no one has taken my picture.

If I cover my right eye, I’m not able to see anything on the left side of my vision.  I’m going blind and I’m terrified.  My only hope is that we get to the surgery center soon enough; my optometrist told me that we might be able to save my sight if we make it in time.

He told me to watch out for things like this.  Flashes and floaters.  That’s what he said at my last eye exam.

Oh God please don’t let me go blind.  Please don’t let me go blind.  Please-

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ONE HOUR EARLIER

SETTING – OPTOMETRIST EXAMINATION ROOM

DOCTOR VOICEOVER

Man I am so full from lunch I can hardly move.  I hope that Altoid was enough to kill the onion breath or this patient is going to be knocked unconscious.  Thank God this has been a pretty straightforward exam so far because –

Wait.

Is that what I think it is?  He didn’t tell me he’d had any new visual symptoms; I know last year I told him to let me know if he ever saw any flashes of light or a bunch of new floaters in his vision.  Yeah, that is definitely a tear in the retina.

I hope the retinal specialist is in the office today, because that’s where this patient is headed ASAP.

————————————-

THREE HOURS LATER

SETTING – RETINAL SPECIALIST EXAMINATION ROOM

PATIENT VOICEOVER

So this guy is a specialist, huh?  And did he just say “laser?”  As in, he’s going to shoot a laser into my eye?  I’ll just assume I know what he’s doing; things can’t get much worse now that the blind spot in my left eye has gotten huge.

If he fixes this and I get my vision back, I’m going to get my optometrist a very nice fruit basket for catching this.

————————————-

ONE WEEK LATER

SETTING – OPTOMETRIST EXAMINATION ROOM

OPTOMETRIST

Hey!  It’s so nice to see you again!

PATIENT

It’s so nice to see again!

The Eyes Have It, Part Two [insert cringeworthy joke here]

Welcome back!  Last time we left off with the most anterior parts of the eye, and today, like a proctologist, we’ll be moving posteriorly.  Let’s begin with the crystalline lens.

The lens is probably best known in association with cataracts, although that’s about the same as a loaf of bread being best known for its mold.  Regardless, the lens is where cataracts occur, but it’s oh-so-much more than that.  Secondary to the cornea, the lens is one of the big reasons light focuses in a clear point within the eye.  However, unlike the cornea, the lens can actually alter its power.  Take a moment and consider how cool that is.  I’ll wait.

CONSIDER IT

Have you considered it?  Get this:  based on the distance at which you are looking at something, the lens changes in shape in order to focus the image onto the retina, sort of like a camera lens with changeable focus lengths.  This change is known as accommodation, and it’s completely involuntary.  Now, not to be a party pooper, but there is a downside.  Around the ages of 40 to 50, the lens loses its ability to accommodate, which leads to many people needing reading glasses or bifocals for the first time.  This condition is called presbyopia.

Ever wonder why the eye is round, and what keeps it from changing shape?  Of course you haven’t, you’re a busy person with other things on your mind.  But let’s lie to ourselves and pretend that you’ve actually pondered this; the simple answer is a jelly-like substance called the vitreous humor.  The vitreous starts right behind the lens and fills the majority of the eyeball itself.  Given his history with Jell-O, Bill Cosby would probably be a pretty good advocate for the vitreous.

There's always room for vitreous.

The vitreous is responsible for harboring those little threads that you sometimes see when you’re looking at a bright background, like the sky.  Some call them ‘floaters,’ ‘floaties,’ ‘mosquitoes,’ ‘spots,’ and some people think there’s a mouse in their house that runs away every time they try to look at it.  Well, that self-conscious mouse is actually a particle that’s suspended within the vitreous, which, when light hits it just right, casts a shadow back onto the retina and is perceived as a floater.

Speaking of the retina, let’s wrap up this discussion of the normal eye with the big daddy itself.  If you think of the eye as a camera, then the retina would be the film (no, the camera in this analogy is not digital, stay with me).  The other optical components of the eye all cater to the retina; without a clear image being focused on the correct spot, all we see is blur.  The whole point of wearing glasses or contact lenses is to manipulate light into focusing onto the macula, which is essentially the central area of the retina that is responsible for our most critical vision.

Ever heard of rods and cones?

Close, but no.

Of course you have!  If there’s one factoid about the eye that everybody knows, it concerns the rods and cones.  These important cells reside in the retina, it is their home, their refuge, their sanctuary.  Rods and cones are the essential parts of the retina that absorb light, hence why they fall under the collective term photoreceptors.  Rods and cones are the starting point of vision, at least as far as the absorption of light is concerned:  they start a chain reaction that eventually sends signals to the visual section of the brain.

Another important part of the retina is the optic nerve, which serves as the cable by which those electrical signals we just talked about are transmitted from eye to brain.  For reference, here’s a picture of the retina:

The red lines are blood vessels, and that yellowish circle where they all come together is the optic nerve.  To use one of my favorite analogies (because I love doughnuts), the optic nerve resembles a doughnut, with an indentation in the middle known as the cup.  The size of this cup is measured in comparison to the size of the whole nerve itself, and this ratio helps us eye doctors determine if a person has glaucoma.

I hope that’s not too much of an information overload; I’ll cut it off here. Really this is all just a light skimming over the parts of the eye. If ever you have any questions about eye-related things, drop me a line; I’d love to help.

And just because it sounded so good last time:  until we meet again, take your protein pills and put your helmet on.

Flashes and floaters and bears, oh my!

Once I thought I was having a stroke.
 

It was the summer of 2008 and I was between the first and second years of optometry school at the time.  To celebrate finishing our harrowing first year, three optometry friends and I decided to set off on a trip to Europe for a backpacking adventure.  Our plan of attack was ambitious but left us with little time to dwell on the finer points of each stop:  in one month’s time we hit Paris, Brussels/Brugges, Amsterdam, Berlin/Potsdam, Prague, Vienna, Venice, Rome, and Florence.  We rode the Eurail from place to place and spent an average of about three days at a hostel in each city.  It was easily one of the most memorable times of my life.

With that backstory in mind, here’s where my suspected stroke comes in.  Our train had just arrived in Prague, and I was especially pumped since my Czech background is one of the few pieces of my ancestry I am aware of.  Upon donning my 30-40 pound backpack (a big orange sucker that made it impossible to lose me in a crowd), I disembarked the train behind the rest of my friends.  We marched down the boarding area amongst the other travellers just as we had at the last several destinations, and that’s when it hit.

My backpack seemed heavier, almost seemed to be pinching at my shoulders.  The sounds of people around me began to fade in and out, changing gradually in volume like an auditory wave of peaks and troughs.  Then the visual symptoms began.  Now, as an optometry student, I had been fairly familiar with all of the possible causes of transient visual obscurations; that is, flashes of light, temporary vision loss, floaters, etc.  However, when the left half of my vision disappeared entirely, all of that knowledge was somehow absent from my conscious mind.  Maybe I left it back in the States when we flew from Jersey to Paris.

So anyway, the left HALF of my vision was gone.  50% of my world had vanished.  I was a little alarmed.  And when I say a little alarmed, I mean that my internal voice was sounding off like someone about to die in a horror flick:  OH MY GOD WHAT’S HAPPENING IS THIS REAL LIFE NOOOOO

SYSTEM FAILURE - I think my brain just broke.

I was frightened beyond the capacity for rational thought.  All I could do was mechanically try to follow my travel-mates to our hostel, which seemed painfully far from the train station.  Along the way I mentioned what was happening to my friends and I think I actually muttered the words “I think I’m having a stroke.”  We decided to soldier on, or at least I think that’s what they decided as best I could hear through the ringing that had begun in my ears.

An eternity later we arrived at the Chili Hostel, which turned out to be a pretty sweet place to stay.  Nothing about it stands out particularly – it didn’t have the best breakfast, didn’t have the best beds, didn’t have the best company – but it supplied us with what we needed during our short stay in Prague, which was a bedroom off of a central common kitchen area and communal showers that borderline worked.

I could talk about aspects of that European jaunt all day, but I’ll stick to the point.  Visual obscurations are NOT FUN.  Mine actually turned out to be the visual manifestations of a migraine-to-be, which although it sucked at the time, turned out to be much less serious than a stroke.  However, many flashes of light or losses of vision are not so benign – they can be something as inocuous as an ocular migraine to something as vision-threatening as a retinal detachment or life-threatening like an episode of cerebral ischemia (or in other words, the blood ain’t gettin’ to your brain).  Symptoms like these should always be checked by an optometrist, who can dilate your eyes, assess your pupil function, and perform similar tests to rule out serious conditions and make an appropriate referral should something more malignant be suspected.

Luckily for me (since I didn’t speak the local language, let alone know where to find the nearest doctor), my vision loss only led to a head-shattering migraine.  After sleeping for about an hour, I was at least 50% better and feeling good enough to go out on the town and Czech out the nearest bar to drink the rest of the pain away.  I’ve only experienced the same thing one time since then.

I guess the theme of the story is one of being Lost and Found.  If you lose your vision, find an optometrist.  The treatment may involve medications, or it may just end up being a nice dark room and a nap upon a 20-something year old dirty hostel bed.