MYTHS AND MISCONCEPTIONS IN OPHTHALMOLOGY

Dr.Don-EyreBeckles

Recently I had a startling experience with a patient of mine who had run out of his glaucoma eye drops but he told me he was still in good fettle because he had been using seawater. Seeing my obvious confusion, he explained, and I quote, “the sea water burns the same way as the drops so they are the same thing”. I didn’t know whether to laugh or cry since he was in the advanced stages of glaucoma and could not afford to miss a single day of medication. This experience made me think of other misconceptions that some patients and lay people may have regarding eyes in general and various ophthalmologic procedures.

Glaucoma

Glaucoma is a progressive disease of the optic nerve which may be associated with raised eye pressures. It can be managed but not cured. Regular monitoring of the condition is required to ensure the continuing efficacy of the management method since it can lead to blindness.

At least two patients in Barbados have lost their eyesight believing that L-arginine was a cure for the condition and found out the hard way that it is not. Blood pressure and intraocular pressure are separate and distinct entities as much as oil pressure and coolant are different in a car. Sometimes there are correlations between the two, but this happens in less than 10% of people.

A diagnosis of glaucoma does not imply that a person will necessarily go blind but rather that they must have treatment in the form of drops/tablets, lasers, or surgery in order to gain control of the condition.

The only herb known to have any effect on eye pressure as seen so often in glaucoma is tetrahydrocannibol, (Marijuana). However various attempts at commercializing this drug have failed because the effects are not long lasting enough. Coffee is also known to reduce eye pressure but would require quantities that may have significant cardiovascular side effects.

Cataracts

A cataract is a condition where the lens of the eye becomes cloudy making clear vision problematic. A few years ago, I had another experience with an elderly lady who announced that she had had cataract surgery performed in the United States and during this procedure her eyes were removed, cleaned, polished, and replaced. I assured her that cataract surgery did not involve removal of eyes and that the procedure was done with the eyes in place, but she was having none of that since, as she put it, “you wouldn’t know”. The truth is that removing the eye or even placing tension on the optic nerve will have dire consequences for the future function of that eye.

Cataracts do not return after cataract surgery, however, the capsule where the cataract was housed and where the artificial lens is subsequently placed can become hazy giving an effect similar to cataract surgery, but this haziness can easily be fixed with a very short, quick and painless laser procedure.

Laser cataract surgery is not likely to be done in Barbados largely because of the cost of the lasers and the fact that after being cut up by the laser, the cataract still needs to be removed from the eye - by the same technique that is currently being used anyway . What is commonly referred to as laser cataract surgery is actually one of the most modern techniques referred to as phaco-emulsification. This involves the use of a high frequency vibrating cutting tool which dissolves the cataract while aspirating the emulsified cataract debris from the eye.

There is no truth to the rumor that cataract surgery cannot be performed on a person with glaucoma or diabetes.

Catarct surgery can be performed on both eyes on the same day.

There is currently no known medication or drop which can melt or dissolve cataracts.

Heat, such as from cooking after cataract surgery will not affect it more than any normally healthy eye that has had no procedures done. Interestingly, bending, such as to tie a shoelace or to pick something up off the floor after modern cataract surgery, will have no negative effect on the eye after surgery either.

Glasses And Foreign Bodies

Glasses or spectacles do not contain medicine which wears out over time. The prescription of spectacle lenses refers to the shape that is cut into them to help light be directed perfectly onto the retina. Over time the requirement may change resulting in the need for a new prescription. The flip side to this is that occasionally a person who needed glasses in childhood can occasionally grow out of that need and happily not require spectacles anymore.

Despite a person having 20/20 vision with an old pair of specs does not imply that the person can simply copy their old prescription into a new pair of glasses. Of course, sometimes this can work out but in many more cases it doesn’t. It’s a little bit like purchasing shoes; even though we know our foot size, it’s always prudent to try on the shoes before buying them.

Over the counter reading glasses will not damage your eyes; increasing the strength of them over time is a natural progression. Reading in the dark with or without glasses, will not ruin your eyes. They will probably get tired sooner but outside of this shortterm tiredness, there are no ill effects.

Sinusitis, does NOT affect your eyes, but allergies may trigger your sinuses and conjunctiva at the same time thus giving the impression that one leads to the other.

Foreign bodies such as dust being blown cannot get to the back of your eyes even if they make it to the inside of your eyelids.

I’ve saved my last two classic Caribbean eye myths to the end. Putting urine into your eyes will not prevent pterygium growth and in fact can put a person at risk of contracting urinary tract and even sexually transmitted diseases in their eyes.

Finally, sleeping in direct moonlight will not give you a “cold” in your eyes. Let’s leave the moonlight blame to other acts of lunacy.

Dr. Don-eyre Beckles MBBS

FRCS (Ed) is a graduate of UWI and a fellow of the Royal College ofSurgeonsofEdinburgh.Heisa comprehensive ophthalmologist in private practice for the past 23 years