Wednesday Words I Love

How many optometrists does it take to change a lightbulb?

One....or two.....one.....or two.....

I'm adding onto this 'Wednesday' post because something has caught my interest and I want to share.  I can't talk about any specific optometry patients on this blog, or anywhere else for that matter.  HIPAA demands that my patient's information remain private, which is a good thing.  I wouldn't want my doctor talking about me on the web either.  However, I can talk about my husband, who is technically not even my own patient (he saw another intern) :)

So, Allen has something called latent hyperopia.  Hyperopia means basically that he is far-sighted and needs plus glasses or contacts.  However, the funny part is that Allen wears glasses to correct myopia which is near-sightedness and is corrected with minus glasses.  They are completely opposite.  That's where the 'latent' part of latent hyperopia comes in.  Basically, Allen has hidden hyperopia.  When you do a normal exam on Allen, his eyes tell you that he needs a near-sighted correction.  He will tell you that he can't see with plus lenses over his eyes, and he REALLY can't.  He's not making it up.  However, when we use drops to paralyze the lens in Allen's eyes, suddenly the far-sightedness shows itself for what it really is.

How does this happen? You may be asking.  Why is Allen near-sighted most of the time, but actually far-sighted?  The answer is that Allen's lens inside his eye is locking up.  Everyone's lens is movable and just like a real lens it focuses light.  This is the same lens that when you get older, becomes a cataract and must be removed and replaced.  In normal eyes, when you look up close, your lens becomes fatter and allows the light rays to focus for up close viewing, then when you look far away, it relaxes and becomes skinnier.

Allen's lens is stuck in the 'fatter' position.  The muscles (actually called the 'zonules of zinn') that make his lens fat are stuck in a taught position and are not letting up.  Only when my colleague put special drops in his eyes to force them to relax, could they really allow the lens to go into its skinny position.

So, is this a problem?  Technically, yes and no.  Its not uncommon and as long as Allen is young, he can simply wear the near-sighted correction that he has, the only thing different that he has to do is take off his glasses to read.  However, as Allen gets older, his lens, just like everyone else's will start to deteriorate.  This is why most people need reading glasses.  If we don't do anything about the latent hyperopia now, Allen may need reading glasses sooner than most people.  Actually, that is why he is already having to take off his near-sighted correction to read.  Its also pretty annoying for Allen to know that if we could get the problem fixed, he could probably go without glasses or contacts at all.  His far-sighted correction is much lower than his near-sighted.

So: the outcome is in the 'to be determined stage.'  Today and yesterday Allen is attempting to go without any correction at all.  All that needs to happen is for his zonules to release the tightening that they have on his lens and this might be achieved through wearing no glasses.  However, he's dealing with blurriness, and we're not sure how long it will take.  I am also researching other ways to relax his eyes.

He is my own personal science experiment right now! :D  Glad he doesn't mind.

I'll keep you guys updated on the outcome.