Dr. Cranquis' Mumbled Gripes
(Disclaimer: Questions related to medical topics will be answered to the best of Dr. Cranquis' (and Google's) knowledge, but the internet-delivered wisdom on this blog CAN NOT AND SHOULD NOT SUBSTITUTE for your Real-Life Doctor's personal attention + examination, and your own common sense too! If you think you're having a medical emergency, hang up and go email 911. The author of this blog takes no responsibility for any medical, relationship, scholastic, financial, or other decisions you may make based on information found in this blog.)
And since people seem to be a bit confused about this: any "real-sounding" patients names are just horrible puns, and not HIPAA violations.
- Cranquis *preparing to do an eye-dye black-light exam*: So did you sleep with your contacts the night before you woke up with painful red eyes?
- 18-year-old patient *defensive*: Yep.
- Cranquis: You shouldn't sleep with your contacts in. Even the ones which are sold as "ok to sleep with" can still increase your chances of getting corneal ulcers and infections.
- Patient *using a tone of voice which implies I'm a dummy*: Well, I've always slept with them in, and I've never had a problem.
- Cranquis *peering through the black-light scope*: Until now.
- Patient *using her voice to roll her eyes, since her actual eyes need to be still for the exam*: The contacts aren't the problem. I asked my friends, and they said it's just allergies in my eyes.
- Cranquis: Hmm. Well in that case, you've got allergy-induced corneal ulcers -- and darned if they don't look just like the ones that you get from sleeping with contact lenses.
- Cranquis: Well you've got a stye in your eyelid.
- 70-something male patient *doesn't skip a beat*: Uh-oh, you think I got it from eating pork?
- Cranquis: Huh?
- Patient: Cuz I thought maybe it was a pig stye.
- Cranquis: *shakes patient's hand with a mixture of amusement and awe*
- Cranquis: Ma'am, I understand your concern, but you really don't have any symptoms of infectious pink-eye. I think it's your seasonal allergies causing the itchy eyes.
- Patient *frustrated*: WELL FINE THEN.
- Cranquis *offering hand to shake*: Do the treatments we've discussed, and you'll get better.
- Patient *shaking my hand with a look of amazement*: WOW, I GUESS YOU REALLY DON'T THINK IT'S AN EYE INFECTION, IF YOU'RE WILLING TO SHAKE MY HAND. OK, THANKS DOC!
When looking at a mirror, that fixed point is usually the person himself.
That’s why if you hold a mirror in front of a person and keep rotating it slightly right and left, his eyes will keep jerking right and left to follow his own image, and that’s quite entertaining to watch.
This is sometimes used by ophthalmologists to detect malingering patients pretending to be blind (to escape military service for example). The patient won’t be able to resist following his own image.
I LOVE physical exam findings/tests that catch malingerers in the act!
So, yeah.
If your vision in your right eye has repeated episodes of “my vision looks like butter smeared all across it” every day for 6 months, maybe you should see a doctor about that sooner.
Especially if you have atrial fibrillation, but refuse to take warfarin (a blood thinner to prevent blood clots from developing in your jiggling atria) and just take a “natural supplement to prevent clots” instead.
And you’ve had 8 heart attacks, but refuse to get cardiac vessel catheterization.
Because guess what, sir?
Now your massively clotted and narrowed carotid artery refuses to let the blood flow through properly.
(99% occlusion of carotid artery on ultrasound — yeesh.)
This is what the normal eye looks like
I want you to pay close attention to the pupil, which is black circle in the middle of the colored iris. The pupil is in fact a hole through which you can only see blackness, but right behind that pupil lies an important eye structure, the …
Hey you. Yeah, YOU, the science/medical-minded follower. You oughta check out this guy’s blog. He’s an MS4 med student in Egypt with a passion for ophthalmology and a gift for explaining medical/scientific stuff in an interesting way. So now you know.
![Hey, Dr. Cranquis! I’m pretty stoked that I get the chance to send a message at last. :) Anyway, what do you think is the most beautiful, fascinating thing about the human body, and why?
Hey there! I’m glad you got a chance to send such an intriguing out-of-the-box question, thank you!
I am most fascinated by The Human Eye. That is one amazing organ! There is so much going on in that little ball of nerves, blood, muscles and GOO — and we hardly control any of that consciously! The physics of optics, all the emotions that it (along with it’s best friends, Eyelid and Eyebrow) can express, the ways it compensates for light changes, the physical clues it can provide to major system-wide diseases — WOW. And then, just for the heck of it, it comes in a variety of iris colors! How cool is that? Your body and brain obviously value your eyes highly, too — so many of your body’s neural “emergency” reflexes are centered around protecting the eyes and face.
Further, from a philosophical viewpoint, the eyes are The Windows To the Soul (source disputed, possibly old English or Arab proverb). You can learn so much about someone by watching their eyes, plus you can learn a lot about someone by examining what they choose to watch with their eyes.
And last of all, my favorite Bible verse of all time has to do with eyes:
For whoever touches you touches the apple of His [God’s!] eye. [Zechariah 2:8]
Have you ever been poked in the eye? That’s immediate all-encompassing pain, felt to your very core! You will do anything to protect your eye from getting touched (trust me, I have to wrestle people’s eyes open all the time when doing exams for corneal abrasions and foreign bodies). So to me, this verse says that God’s natural instinct is to protect me in the same way that I try to protect my eye — and that if I do feel pain, He feels it too. Awesome. :)
***Pending Cranquis-Mails: 2; Inbox: Closed***](http://24.media.tumblr.com/tumblr_lw7lz7gJ8i1qcw86wo1_500.jpg)
Hey, Dr. Cranquis! I’m pretty stoked that I get the chance to send a message at last. :) Anyway, what do you think is the most beautiful, fascinating thing about the human body, and why?
Hey there! I’m glad you got a chance to send such an intriguing out-of-the-box question, thank you!
I am most fascinated by The Human Eye. That is one amazing organ! There is so much going on in that little ball of nerves, blood, muscles and GOO — and we hardly control any of that consciously! The physics of optics, all the emotions that it (along with it’s best friends, Eyelid and Eyebrow) can express, the ways it compensates for light changes, the physical clues it can provide to major system-wide diseases — WOW. And then, just for the heck of it, it comes in a variety of iris colors! How cool is that? Your body and brain obviously value your eyes highly, too — so many of your body’s neural “emergency” reflexes are centered around protecting the eyes and face.
Further, from a philosophical viewpoint, the eyes are The Windows To the Soul (source disputed, possibly old English or Arab proverb). You can learn so much about someone by watching their eyes, plus you can learn a lot about someone by examining what they choose to watch with their eyes.
And last of all, my favorite Bible verse of all time has to do with eyes:
For whoever touches you touches the apple of His [God’s!] eye. [Zechariah 2:8]
Have you ever been poked in the eye? That’s immediate all-encompassing pain, felt to your very core! You will do anything to protect your eye from getting touched (trust me, I have to wrestle people’s eyes open all the time when doing exams for corneal abrasions and foreign bodies). So to me, this verse says that God’s natural instinct is to protect me in the same way that I try to protect my eye — and that if I do feel pain, He feels it too. Awesome. :)
***Pending Cranquis-Mails: 2; Inbox: Closed***
beadoer submitted:
I work for an ophthalmologist. This morning a patient phoned in requesting a conversation with the doctor. I usually screen the calls but because he was in the rooms and we had hit a rather quiet lull I put the call straight through.
*Doctor walks out*
‘Do you know what that patient phoned in for?’
‘No?’
‘He said, when he takes his glasses off his vision gets really blurry’.
‘Haha…wow I could have taken that myself.’
Bwa-hahaha! XD
My nurse almost vomited when she saw this patient’s eyeball. It looked like somebody had painted streaks of White-Out all over her cornea.
- Cranquis: Your chart also says that you have blindness in your left eye?
- Patient: Oh yeah, it's because my eye has that problem, um, I forget the name -- it's like the name of a dessert.
- Cranquis: Um...
- Patient: You know, that dessert, it's like a salad with coconut and fruit and whipped cream?
- Cranquis: Uh...
- Patient: Ambrosia!
- Cranquis: Amblyopia!
- Both: *laughter*
Hi there, Blurry Butterfly! I’m glad your optometrist is taking that finding seriously and sending you to an ophthalmologist. Let’s hope it truly is “nothing”, because a swollen optic nerve can be a symptom of various problems (increased pressure in your skull from various reasons, aka papilledema — or other problems like high blood pressure in the eye, infection in the eye nerve, or various rheumatologic or neurologic conditions). The biggest consequence would be vision loss, of course. The other possible “outcomes” would depend on the cause. I’m not an eye specialist, so my knowledge kinda runs out right about here… sorry. Good luck!
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Yes.
(Hey, that’s an easy question to answer!)
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(Seriously though, Nice Tag Mouse, I don’t have any input on that symptom. Not trying to be sarcastic or anything.) :)
Just related to some stuff we chatted about a while back. Thought you might like a look. Also, how awesome are the potential applications for Kinect?! :
http://www.psfk.com/2011/03/gaming-thats-good-for-your-health.html
Gotta love science.
cranquis Said:
Excellent, thanks for that “update” to our discussion about Deep Brain Stimulation!
I had seen part of that pro-videogame article (the section on using the Kinect to operate an MRI image viewer in the OR), but the other section about identifying kids with visual problems QUICKER with the 3D gaming handhelds was really slick!
Yay science! :)
***Pending Cranquis-Mails: 25***
Anonymous Asks:
For the past couple of days I have noticed a decline in my eyesight. From what I've looked up it seems as if I may be becoming nearsighted. I can see things clearly that are up close, such as books, but if I'm looking across a class room the writing on the white board is legible but clearly blurred.
I'm twenty years old and have never had vision problems in the past, in fact I've had excellent vision all of my life.
I've tried to pass it off as a sensitivity to the florescent lighting at my work, but I can't use that excuse anymore as I've notice the vision problems more frequently in other lighting situations.
I'm not sure if this can be attributed to swimming in my fitness center's indoor chlorinated pool without goggles, but that is the only recent thing that I can think of that may be a cause.
Also I've read several (and possibly bogus) articles online that imply that getting an eye exam and ultimately being prescribed glasses will only serve as a crutch, and may ultimately worsen the condition (assuming it doesn't just go away if I stop swimming). And that eye exercises may serve as a cure.
Your educated opinion would be lovely.
cranquis Said:
Greetings and salutations, Blurred Beluga —
Yeesh — if your eyesight is actually getting worse quick enough for you to notice it that much, you need to get it checked out soon. Aside from the common ocular causes of “nearsightedness”, there are quite a few medical conditions which could be involved, including diabetes, thyroid problems, neurologic problems, and electrolyte imbalances. I’m not an eye specialist, so I’m not sure whether the chlorinated pool can be blamed for it.
However, I do know that those hokey internet articles which claim that “glasses only serve as a crutch” are ironically correct: glasses or contact lenses act as an accessory lens for eyes whose natural lenses are not working well on their own, in the same way that a real crutch functions as an accessory leg for a person whose leg is broken. DUH! Vision is all about light waves and the properties of bending and focusing light on a point; if your built-in vision equipment isn’t working, you add another lens to the system to compensate.
Furthermore: If the optical portion of your eye (a complex INTRA-eyeball mechanism involving a self-adjusting lens and iris which are controlled by the autonomic [i.e., reflexive, not-consciously-controlled portion of the nervous system] nervous system), which in turn integrates with a series of nerves and brain centers to convert light waves into brain signals, doesn’t work, how in the heck could “eye exercises” (which would likely involve the muscles AROUND the eyes, which only control which way the eyes are pointing and how your eyelids stay open) improve your vision??! Hogwash.
Ok, go see a real eye doctor, and stop reading the internet (hey, maybe THAT’S why your vision is getting worse! What kind of naughty websites have you been visiting? LOL!) :)
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