By GARY ASANO, O.D, FAAO
Do you ever say to yourself, “Who is that, and what is their name?” Sure you do, because we only have so much room in our brain! Or, at least that sounds better.
It’s a whole process of seeing objects and people, and then recognizing. And it involves seven association areas of the brain.
Our optic nerve is really long and connects with the visual cortex that is near the back of our head … and then transmits to those Brodman association areas. Then all of those steps are involved for our brain to recognize, interpret and process.
So it’s a lot more than the most sophisticated camera. It’s also the most protected of the 12 cranial nerves by a number of layers.
In some cases if a stroke involves one of those association areas, one can see a light switch and know what it’s for, but not know the name for it. The same type of process can be responsible for a person now holding their reading material upside down on a hard copy.
So the next time you don’t know that person’s name, it’s not your whole brain involved!
Now remember last time, I said, “stay tuned for more”?
It’s because the front of the eye, the cornea, has such a tremendous amount of power at 40 diopters, that is equivalent to twice the highest-power lens that almost any optical lab can make!
So anything that makes it uneven, or the film of tears irregular in spreading over it, will really affect your vision.
Of course by now, you’ve heard of a “dry eye.” That could mean that there are not enough tears produced by the three different glands in our eyelids. Or actually more likely, it’s instead that the film of tears isn’t spreading uniformly across the cornea.
So if that happens, the vision is very affected and irregularly blurred. You probably wipe your glasses, blaming them.
One of the reasons for a dry eye is becoming much more commonplace, because of not blinking enough, or completely. Research has shown since the ’70s that on a full-size computer monitor, we blink only about two-thirds as much as in normal everyday life.
So think about it. If you’re staring at your smartphone or tablet, especially when you scroll through multiple pages, that blink frequency is decreased even more. And a “dry eye” is now created.
Our reservoir for the tears is between the lower eyelid and the cornea. When we blink, our tears circulate counterclockwise to fully cover the cornea. But there are too many times when a person now is incompletely blinking, and just halfway. Yes, you guessed it! The tears haven’t circulated at all and that reservoir is not replenishing the eye.
All is not lost, though, because back in the 1970s, a brilliant optometrist, Donald Korb, in Boston realized what was happening, so people’s contact lenses became unwearable even though the fit and material was more than adequate.
He developed a series of blinking exercises. And they definitely work. I’ve seen 99% of patients improve in their symptoms, and their blinking pattern. Of course there were a few who on the return progress visit said sheepishly that they didn’t do the exercises.
They are available on an app … just look for the name “Korb” associated with whatever video or app you find. Artificial tears work, as we talked about previously, but it’s a complete package of our blinking fully too.
There are also eyelid infections called “blepharitis” where there’s an infection of the oil glands at the base of the eyelashes. Symptoms are when you wake up in the morning, of the eyelids struck together and dried mucus being the culprit.
Yes, one can wipe them away. However, it’s produced during the day too … more at night since the eyelid temperature is higher … even if you toss and turn.
There are no specific antibiotics for this condition, but using OTC eyelid scrubs available from several companies, at least at night before retiring, and in the morning, actually knocks off the dried mucus and bacteria when done very regularly, then air temperature does wonders.
The reason for even bringing this up here is because if left untreated, the flakes of mucus will fall into the eye, and also be a cause of a “dry eye.”
That condition can be the cause of red eyes, though there are a number of reasons. The artificial tears, if not used enough and regularly, can also be a cause of red eyes.
And allergies do also, but itchiness accompanies that. For an actual allergy condition, by far the best drop to use is Zaditor (ketotifen fumarate). It was a prescription only for many years, and fortunately when it became over the counter (OTC), it was only 15% of the cost.
There are other OTC drops that “get the red out” that secondarily claim to be for allergies, but why not use the actual formula?
Now for red eyes, too many OTC formulas are a decongestant, just squeezing the walls of the blood vessels so that they look better. But what happens when that wears off? Yes, more is needed, and the reason for the red eye is not even addressed, but it’s possible there is a far more serious reason.
Especially if your eyes are now sensitive to light, it usually means that the iris (colored portion of the eye) is inflamed. That is a serious problem and needs to be looked and treated by an eye doctor. It’s not advisable to see your primary care doctor or urgent care, since the amount of education they get on the eyes isn’t enough and they don’t have the proper equipment. Prescribing an antibiotic when an anti-inflammatory is needed instead can cause more serious problems.
98%+ of optometrists have the certification and training to prescribe, so plenty of eye doctors to help you. Yes, there’s more to come!
Gary Asano, OD has been a proactive leader and lectured to a wide swath of low vision rehabilitation for over four decades. Though honored with three national awards, his most rewarding moments are of seeing the innate interest of interns of the two Colleges of Optometry in Southern California. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.