My husband had a viral eye disease they thought herpes but they couldn’t conclude. The eye doctor he was 1st diagnosed by didn’t educate him on the necessary aftercare he needed to do. Because of this he eventually had to have a cornea transplant. The stitches were in his eye for a year.
Dr. G, the next time someone has you testing their prosthetic eye, and they fail even the "can you see this light!" test, tell them you think you know what the problem is... Ask them to pop out their eye, wash it and clean it carefully, dry it, hand it back and say "I think it was just dirty. Try it now." When you're in on the joke...
Opthamologist: we can’t give them a full bottle of topical anesthetics it’ll cause nerve damage ED doctor: then don’t give them a full bottle Opthamologist: goddamnit you’re a genius we need to publish this
I have been visually impaired my whole life. It is weird to me when I inform a doctor that I don't see well. It always surprises them since you can't just look at someone and see that they are visually disabled. It totally catches them off guard and a lot of times they are speechless or they say something completely stupid. The only time this does not happen is when I'm seeing my ophthalmologist. My favorite is when I need to get undressed for an exam and they will ask if I need help getting undressed just because I don't see. That cracks me up.
My son once took out 98% of my cornea luckily enough it healed being able to see better my eye doctor said I was the model eye patient and also had all her colleagues come in to see it and give their opinions on what to do
My 4yo dropped her elbow into my eye and gave me a pretty good corneal laceration. i didn't even cry during labor, but hoo boy, that eye owie took me down.
In my first year of practice as an optometrist, I had to see a 3 year old with a significant corneal abrasion. They were first seen at the Children's Hospital and they called our office to fit him with a bandage lens. I was concerned with finding the smallest diameter lens I could and fearing the upcoming wrestling match to help this child. As it turns out, Children's had given him some narcotics for the pain and he would have let me put a dinner plate on his eye.
Just had a corneal abrasion from my second cataract surgery. Day after surgery, doc asked what the pain felt like. Me: razor blades in my eye. I learned there is a thing called a bandage contact lens which helps with pain/healing.
Yes, she did. She was 2. We were playing and she had a cookie in her hand. As we were roughhousing, I got the cookie in the left eye. When the doc heard the story and looked at it through some gadget, he said, grinning, "Oh, yeah... she took a chunk out of you."
The last time I went to the eye doctor, the assistant pointed at the chart and said, "What does that say?" I could only see blurry lines so I said, "I can't read that." Then she put up four fingers and said "How many fingers?" And I realized that it was the big E and I felt so blind. 😑
Dot Map Fingerprint? It took more than 5 years for my initial corneal abrasion to heal, with putting thick lubricant in my eye every night because of that. And it was my kid also. I was too afraid of the surgery. I still feel a little bit of pain now and again.
I’d love to hear you talk about photic sneeze reflex one day - I am a sun sneezer and find it fascinating! And also, color perception - color blindness and people with extra color sensitivity - is that something that is possible to change in a lifetime?
@@teri2466 yes, it’s in certain other individuals in my family, too! I’ve read up on it in various places, but never from the perspective of an eye dr!
I have it plus all my boys are color blind, my daughter has two different colored eyes & my granddaughter & I have blocked or missing lacrimal drainage holes & one son has glaucoma. All my kids & myself had corrective lenses as kids. I had Jones tubes put in yrs ago!
At 30:00 he talks about the needle tracks for the epithelial cells to adhere to the cornea. You can think of it as more or less the same as sandblasting a car. When you are done sandblasting and spray on the paint, it has grip on the surface and it won't run as much and be more resilient if things touch it. Harder to rip off basically. In my country we don't have a vision test at all for car drivers. Reason can be that we have a fairly long and strict driver training. However, truck drivers have to have a physical every 2 years or so. Or something like that.
The ER nurse told me that the miracle drops prevented the eye from healing and they knew if someone had stolen a bottle because they were back in a week. Kind of glad she didn't mention the melting eye, as I was already extremely nauseous from the pain.
Went to the eye doctor for a check up as well as diagnosing my eye soreness. I hadn’t been since having my 3 kids and was struggling with eye pain, headaches, and trouble driving at night. I was told/scoffed at that my prescription was so low and completely unnecessary. My vision was tested without my glasses on and I managed a 20/40 with many pauses and straining. I was enthusiastically told that I was great since that’s the vision required to drive in my state...the doctor came in, laughed at my low prescription, told me she wouldn’t write me a new one, and suggested eye drops because my eyes were dry. Weirdest eye doctor experience I’ve ever had.
I saw the title of this video yesterday but decided to watch another one- but then literally this morning my cat decided to run across my face and I swear he gave me a corneal abrasion so I had to come back and watch this one! Crazyyyy
I guess it’s a blessing I wear glasses all the time. Eye protection is my secondary benefit! Then your baby learns to grab your glasses, part of their mastery plan to poke daddy’s eye!
Hey Doc, can we please get a video on the issues nurses are facing everyday. They were overworked , underpaid and severely burnt out. I would love to see you talking about their issues
I once was lying in bed and wanted to pull the blanket up but pulled too hard, lost grip and slammed the nail of my thumb into my right eye while it was open. Bad times were had for the next three days!
Kid i knew when i was young got a corneal abrasion from a cheese-it lmao. His buddy threw it at him like a salty little ninja star. _Woosh_ right in the eyeball.
I get to see a number of corneal abrasions caused from kiddos as well as the occasional iritis from a minor kid whacking their parent in the eye a few days prior.
Yeah, my sister got me when she was ~4 and I was ~6. I just remember it Hurt but was better the next day, and I may have had to learn to take pills for the following course of antibiotics; I think we went to the regular doctor for treatment. Also, could you talk about the sort of damage that staring at screens longterm, particularly screens in a darkened room, can do to your eyes? My lab runs some fluorescent microscopy work that involves a completely darkened room, lasers, and staring at a computer screen, and after only an hour your eyes start to hurt. One of my seniors says running it long term messed up her eyes pretty well- what does it do?
Not just the effects on the eye, but the effects on the brain. Non-image-making sensors react to light, and signal triggers in the brain that change hormone levels, etc. The cells react to wavelength, and may react to light levels also. And, the hormones affect the circadian rhythms and autonomic nervous system. From an evolutionary standpoint, this gets into the whole Man-cave entertainment center thing, with true-color hi Def 3D fire displays after the work day, and "up at the Crack of Dawn" Rayleigh scattering alarm clocks. Draw your own conclusions. ?
topical anesthetic for corneal abrasion is effing magic. I've had two corneal abrasions, and while my personal 10/10 for pain is pitocin-induced labor with an asynclitic baby, followed very closely by a kidney stone, the corneal abrasion is uniquely disabling for me, because it literally stops me from being able to dissociate from the pain at all until that drop goes in. It's like an instant autistic meltdown which stops the minute that drop is there. Full overload.
I just earned a BS in neuroscience a few months ago and I am thoroughly surprised with how much I was taught about the eyes. All “basic” stuff of course but it makes this series so much more interesting
He talks about having difficulty examining vision for corneal abrasions because of the pain. My dad scratched his cornea and the doctor asked him if he had a high pain tolerance. My dad was like”I dunno, why?” And the doctor said “because that looks like it hurts”.
I work with a cornea specialist. The patients we see with ulcers, abrasions, and other injuries/conditions, are in complete agony. I feel real bad for them, and now very protective about my eyes
Hey doc, can you talk about your relationship with optometrists and when you should go into see an Optometrist vs ophthalmologist for the cases you go over? - Student OD Ps: I know but the public may not know who to go to first
I had a corneal abrasion a decade ago along with other injuries. Happy to report my ED provider did not page an ophthalmologist! They gave me antibiotic ointment for it and I saw an ophthalmologist the next day. Thank goodness they didn’t melt my eyeball. They did well. I didnt get a bandage contact, though. I would’ve appreciated that. It really hurt.
I'm a radiology resident. why am I listening to eye stuff when I should be studying radiology? 😅 Do one about what happens when you stare at a screen for a 26 hour shift 6 times a month for 5 years (in addition to the rest of the regular work hours for the rest of my career).
The other good reason to have reading glasses around in the ED, Urgent Care, etc... there's a fair number of my fellow Gen X physicians who haven't yet acknowledged that they are in the throws of presbyopia and forget that they need glasses to do certain things -- like get a cath urine on a newborn female (not something non-peds nurses do enough to be comfortable enough to be comfortable with, and not something not something pediatricians do often enough to realize that they now need reading glasses to do...)
You should interview a veterinary opthalmologist. I'm just a GP veterinarian and corneal abrasions/ulcers are one of the most common things we treat. We treat most of them in house: topical antibiotics and usually something to promote healing like blood plasma eye drops or a commercial equivalent. Sometimes we use bandage lenses, sometimes we have to debride an underrun ulcer, sometimes we do grid keratotomy. We use proxymetacaine for our minor eye surgeries which comes in a little single use vial and has like 5-10 drops in it. Not sure how much but it's always more than we need for a
Dr. Glaucomflecken, I just came here to tell you this thumbnail was *haunting*. Love your videos, excited to see more - not referring to the thumbnail. D:
Topical (heh) one right now. UVC damage to the eye? There have been at least 2 parties in Hong Kong that thought UVC germicidal lamps looked really cool and used them in place of regular blacklights. You can imagine the fallout.
Had a corneal abrasion from removing a contact lense that was stuck on my eye from driving on a very windy day with the windows of my car down. It was not painful. I was mad with the optometrist who had to see me daily for 10 days. Oh, I could get an infection is it was not looked at every day. Antibiotic drops would have been easier than this eye exam.
I have had a few corneal abrasions from sports growing up, and I always got the topical and a take home dosage for 24 hours worth of drops! Life saving for a 10 year old who could not wear contacts
Two corneal abrasions. One by a screw that was unobservably under a lot of tension from the cable the three of us guys were pulling and flew out of the wood backing board. Two months after my PRK procedure. The glasses would have prevented the injury. A few months later, another one. I was hit in the side of the face by a basketball and the surface made it to my eye before I could flinch. I’d been hit by a bball dozens of times in the past with nothing coming even close to actually hitting my eye. 😕
Can you talk about keratitis vs conjunctivitis, please? Btw, I think it would be hilarious if you do a video of ophthalmologists vs pediatrics, where you (ophthalmo) refer to kids as "hazardous humans".
When you talk about depth perception with one eye, might also be interesting to talk about why some people have issues with stereoscopic movies. There's a whole bunch of interesting responses from just not being able to perceive the 3D effect, to finding it nauseating :)
I work as general practitioner in Finland and we have about 10 lectures, 5 group lessons and 2 actual ophalmology patients we treat with help from actual opthalmologist in med school so maybe a bit more opthalmology that you have in the states. We usually treat eye patients slightly longer before sending them to opthalmologist. For corneal abrasions we usually just use topical anesthetic in the ER and give chloramphenicol oinment to prevent secondary infection and maybe help a little with the pain. Then we check the patient ourselves after 2 days and only send them to opthalmologist if the abrasion hasn't healed. I found this very interesting and might try this short course of topical anesthetic!
Listening to you talk about corneal abrasions is making my eyes ache... it's been decades, but I do recall the horrific pain of that!! Active labor has nothing on it. 😵💫
I could sit and listen to you talk to all of the eyeball drama stories all day. Even if it's the same stories. We need more of these. More eyeball medical drama - like the topical eyedrop kerfluffle
I had my entire left eye go offline for several months with autoimmune uveitis at 29 and was like , "So I guess this means you're taking my license?" and I was horrified to learn the 20/40 in one eye law. I absolutely could not have been driving and switched to the bus. It horrifies me that people won't give up their license voluntarily at that point now. I would argue that the law should be modified to stipulate that your driver's side eye has to be 20/40. Also, part of my uveitis pain management is a judicious use of closed eye, cold compress ice packs. I'm surprised more eye doctors and ER's don't recommend that. My other piece of lived experience is that eye drops always end up in your nose/mouth no matter how well you press on your tear duct, and no one should be swallowing that much topical anesthetic. I feel like that is a real danger issue for your throat function.
i once encountered a child whose cornea teared from the sharp end of her notebook. honestly one of the saddest event because she was really young and a very cute girl
I had a corneal abrasion in both eyes when I mis-wore contacts way back in the day. I had built up to 10 hours and missed a day, then wore them all day, the following day. Had an eye patch over both eyes for 24 hours. A few years later, I poked my eye with a hairbrush and only wore one eye patch (my second day of college). Oh, the embarrassment! Years later, gave up contacts. Decades later, had LASIK in my left eye and PRK in the right. One eye was corrected for more distant vision and the other for closer vision. I can get by without reading glasses much of the time.
I remember going in for a scratched cornea decades ago. Couldn't wear my contacts, obviously, and no back up glasses. "What's the lowest line you can read?" "I can't read any of it, I don't have my contacts in." Moves me up to 10 feet. "What's the lowest line you can read?" "I can't read any of it, I don't have my contacts in." "Ok, how many fingers am I holding up?" (in a tone that made it clear she thought I was being a bratty teen). "I don't know, I can't see you, I don't have my contacts in." So she walked towards me until I could see her fingers. My eyesight was officially recorded as sees fingers 4 ft, and no one has ever tried to make me read that chart uncorrected since.
Oh, please do an episode on visual snow! I've had visual snow for as long as I can remember, but for most of my life, I thought that was what everyone saw! Then one day I was reading a news article that mentioned visual snow and I looked it up. I would love to hear you talk about it.
I got a deep scratch from the floppy snow crusted ear of a baby Rottweiler. Emergency took a look with fluorescent dye, sent me home with ointment and a black eye patch. Arrr matey!
I knew all the eye test steps because my elementary school nurses would do them all in reverse order if a kid got hit in the face. They'd first test light sensitivity, then hand motion, then counting fingers. However, I don't believe they used a letter chart.
Just started this but woke up one morning 3 years ago with worst pain in my eye. I have a milky covering on part of my cornea and I can't see! I haven't been to the doctor because my estranged husband yanked my vision insurance. I hope I find some comfort, answers, and some guts to go see the Opthalmologist.
I stabbed my cornea with a stick while pulling weeds. It was incredibly painful (worse than a flail chest injury with ribs broken in 13 places!) Three days later, the ophthalmologist snipped the hanging piece of cornea off to instant relief. I wished I was treated as a pants patient!
Thank you for sharing how to do ER vision assessments. As a non medical professional, general person, I now feel confident should I ever go to the ER with eye problems that I can communicate to the doctors what’s happening.
2 am - went to Check on my 3 month old . Wasn’t wearing my glasses .. obviously couldn’t see- dark room - leaned down … you guessed it my little one gave me a corneal Abrasion - probably the worst pain ever
Thanks for acknowledging that you've changed your perspective as you've learned more about topical anesthetic! Melting eyes sound terrifying, but it totally makes sense from the perspective of emergency doctors - as you've said, they probably aren't stocking specialty eye bandaids, so they have to use what they have
Proparacaine is one of the best inventions on the planet. Lifesaver! We keep a bottle at home in the fridge (I'm an LVT, hubby's a DVM) because you never know when something will happen. Even something dumb like dumping pepper onto scrambled eggs in a pan and having the steam blast pepper steam into your eyes. Hubby did that and was in horrific pain, even after flushing. Yep, Lesson learned that day. But Proparacaine saved his sanity.
I actually managed to do the opposite. I was trying to catch my kid when he was a toddler, and he squirmed just right. I caught his eye and gave him a corneal abrasion. I’ve had a corneal ulcer twice. The first time was worse than the second, though, because I went to an optometrist pretty well immediately once I realized what was going on. That is an experience I hope to never have again.
In the Netherlands we apply antibiotic ointment with and eyepad to prevent the patient from blinking. Next day abrasion is almost always healed. This goes for the E.R. as well as the ophtalmologist.
My soon to be husband was unlucky enough to be in the 1% of people with a noncooperative cornea refusing to heal properly. He kept getting abrasions and the iris got infected at some point. It was horrible. So he had to get it fixed. We live in Germany and here they lasered the cornea instead of poking it. He said the smell of the laser burning off some of the cornea was the most disturbing part of the operation 😅 Luckily he's been doing much better but he does have issues with dryness. We suspect that he sometimes sleeps with his eyes open and that that could have effected the abrasions in the first place... Anyway. I really enjoy watching the eye content and your nerdy excitement about all the peculiarities in this field!
“Oklahoma also has a very lax peripheral field vision testing. It’s only 70° horizontally. Now that probably doesn’t give you much perspective.” Yes, I assume that’s the problem.
I've been given topical anesthetic for corneal abrasions multiple times. Nobody told me they were dangerous. I ask more questions now than I used to back then. I was told to only apply the drops when I was applying the other drops they gave me, I think one was an antibiotic and the other was an anti-inflammatory.
My husband suffered a corneal abrasion from my eldest daughter, who was jumping up and down, holding a Boston Fruit Slice! The docs at Boston's Mass Eye and Ear thought that was hysterical. He already had severe eye issues with diabetic retinopathy, so our eye doctor just told us to drive him up to Boston from Cape Cod rather than mess with the local ER. Boy, those guys rode their slit lamps around like rodeo horses. They gave us the topical anesthetic, but I'm a nurse, so...it was fine. Poor guy, though. His eye experiences and the failure to communicate between disciplines were just nuts.
I work at an animal shelter, and I was just teaching staff about flourescine eye stain the other day. Black light stuff is always so fun, ringworm, eyes, cat pee...
My periop nurse gave me the bottle of tetracaine. Ophth was apoplectic when I told him. It saved me though, I used probably 5 drops in 2 days until the pain stopped on its own.
Well this explains why the pediatrician I saw after my eye got scratched thought I was making it up until she put the dye in my eye and realized I wasn't. I was only light sensitive, it didn't really hurt all that much. And my pain tolerance has skyrocketed since then. Like immediately post-op hysterectomy unmedicated was more uncomfortable than painful, I was more sore than anything else. Chronic pain is a joy. 😒
Cool, this is very useful information I can use as a GP. I am actually one of the few GP’s that actually does use charts to test vision, others probably don’t because they either have no time or refer to an opthalmologist anyway. I also do manual fundoscopy. However I kind of lack experience in the eye field 😅
I thought Arkansas for some reason but I think driving starts at probably age 11 and by the time they actually get a license, they're pretty good.😋 Being in Texas, we often travel through Oklahoma when going north since it's right above us. But it's been a few years since I've driven in Oklahoma. Can you tell me why eye drops of any kind are so ridiculously expensive? And prescription eye drops are like tier 4 or 5 on most insurance plans which means the patient pays an arm and a leg for them!🤨 My opthalmologist prescribed drops for dry eyes and the patient still has to pay several hundreds of dollars even with insurance. But the doctor said I can go blind without them. Of course, no one wants to go blind and keeping your vision is a priority but the average person can not afford them! Sometimes there's an advocate for the patients that help those without the means to pay outrageous prices for a constant supply of the needed drops. I just don't get why Big Pharma has to make these drops so out of reach for so many people! A couple of years ago I had a problem with one eye and was given a prescription for antibiotic eye drops. I got to the pharmacy and the drops were $85.00! Thank goodness I checked with Good Rx and only paid $35 for them. But prescription eye drops are so extremely expensive! Just wondering if you have any ideas about why they charge so much for prescription eye drops.🧐 When they start costing more than my rent, I have to wonder.🤔 But I do enjoy your podcasts about the eyes! I've spent a lot of time with my opthalmologist and it's nice to know more about what he does and some of the problems I've incurred. I'm fairly convinced to start wearing safety glasses at all times now!🤓 And I appreciate the knowledge you pass on to us and how we should treasure our eyesight!😘 Thanks for sharing another great video!👍
Thanks for explaining the vision exam in such a simple way! Maybe med schools can just show the 10 min clip instead of fumbling through an explanation :D Also makes me feel less nervous as a patient if I ever have to go into emergency/urgent care for an eye-related issue
