My Opinion

Thanksgiving 2010: My Eyesight Returns

Happy Thanksgiving!  I had a great weekend and hope you did, too.  This year, I am thankful for my friends and family …and especially my eyesight.

Turkey Day

As with many of you, we had a marvelous feast.  We celebrated with our parents, friends and the kids.  Amy did a wonderful job with roasting a turkey, stuffing from scratch and her famous garlic mashed!

I usually smoke a turkey, but this year I fried a turkey!  3 gallons of peanut oil, a 12 lb. bird and 40 minutes is all it took!  No rubs, seasonings or marinades.  I recommend it.  (Actual cooking took place in the middle of the driveway to avoid any potential fire hazards!)

It was a great way to celebrate Thanksgiving.  I’ll be doing it again next year.

Double Vision from Accident

Last winter, I fractured my right orbit.  The orbit is also known as the eye socket.  I had a freak fall that broke my cheek bone…and that resulted in double vision.

Since last February, I had double vision any time I looked to the left.  Fortunately, I had single vision when looking straight ahead or to the right.  I had no problems working and operating as those activities require only that I look straight ahead.

I did, however, have to give up both tennis and kick-boxing.  Neither could I do with double vision.

The broken bone caused damage to one of the muscles of my right eye.  As a result, my right eye didn’t move to the left easily and I saw double.  To compensate, I’d close my right eye when looking to the left, but at the same time, I’d lose my depth perception.

Multiple Operations to Fix Me

I had three surgeries to fix my “eye.”  The first two were performed over the Spring and Summer.  The goal, at that time, was to simply fix the broken eye socket and see if function returned.  I had limited success.

The most recent surgery was about 3 weeks ago.  I immediately saw an improvement and 2 days later hit some tennis balls for the first time in over 9 months!

What Does This Mean? I realized how hard it is to be a patient.  Not only is the vision compromised, but the surgical results were disappointing.  How similar this must be with my own patients with retinal disease!

As a physician, I am now more empathetic and sympathetic to my own patients.  Many of my patients have lost depth perception, and I was surprised how this impacts every aspect of our life!

I would guess that I have about 85% of my function returned (far up and to the left is still weird).  For that, I am very grateful.  I thank my coworkers, family, and especially Amy for helping me through this difficult year.

I am lucky.  I have great support systems and resources.  I am also lucky that this was not a disease.

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Your Retina Sees Backwards

Images on your retina are reversed.  Your retina “sees” everything backwards.  Your brain reorients you.  This image reversal is an adaptive advantage providing us with tremendous peripheral vision and the ability to view objects much larger than just a few millimeters.

Image Becomes Reversed

Everything is Upside Down…and Reversed

The simplest illustration of how your retina sees is shown above.  If you look at the eye chart, it gets turned upside down and reversed on the retina.

The image the retina “sees” is completely reversed.

The brain has to then reorient the image to allow you to see things “right side up” (and re-reversed).

Keyholes are Actually Pupils

Imagine you were looking through a keyhole trying to spy on someone inside a room.  As you are scanning the room, looking at the right side of the room to the left side of the room, you really need to move your head/body in the opposite direction.  This is the only way you can “see” the entire room.

The important point is that you can see the entire room through a very tiny hole.  In the eye, the analogous part is the pupil.

Images need to be reversed so we can see objects much larger than the size of our pupil and so that we may have peripheral vision.

The Washington Monument is Upside Down

Using an example of the Washington Monument may help a bit.  The image of the top of the monument must travel through your pupil and is focused on the inferior, or bottom, portion of your retina.  The image of the base of the monument is focused (along with all the flags) on the superior, or top, portion of your retina.

Light Rays Converge and Cross

What Does This Mean?

By reversing the image, we are able to visualize objects much larger than our eye.  If you look at the light rays, colored in blue (see above), you will notice that the distance between the light rays emanating from the top and the bottom of the chart get closer together as they approach the eye. At some point, they actually cross and reverse.

The image of the eye chart is getting smaller, too.  The light rays get smaller allowing the entire image to fit through the pupil and form a complete image on the retina, albeit upside down and reversed.

Without this reversal, we would have a very limited view of our world.  It would be similar to viewing the world through a drinking straw.

(Note:  For those of you who have had retinal detachment surgery involving gas injection, or macular hole surgery with gas or an intravitreal injection with an air bubble, this explains why the “gas/air” appears toward the bottom of your vision when looking straight ahead.  With your head erect, the gas rises to the top of your eye, giving you the impression that the gas is on the floor,)

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