Episode 89 – The Eye Book By Dr. Seuss
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Dry eye: 48% of Americans over age 18 complain of dry eyes. Caused by environment, genetics, health conditions, eye procedures, medications.
There are 2 reasons for dry eye:
1. Inflammation blocks the free flow of fluid through the eye.
2. Tear duct insufficiency – the ducts and glands don’t produce adequate moisture for the eye (can be solved by a tear duct stent)
If a medication dries up another part of your body, then it has the potential to dry out your eyes (antihistamines, medications for overactive bladder) – these medications can also lead to constipation.
Many of the common diseases that many Americans deal with can cause dry eye – hypertension (high blood pressure), diabetes, obesity.
They light from electronic devices tricks your eyes into not blinking as often, therefore your eyes can dry out more easily (blinking is your eyes’ remoisturizing process). The solution is to give your eyes long breaks from electronic light , especially late at night before sleeping.
Callback: Sleep
Air conditions in hotels can make your eyes feel dry because they work to remove excess humidity from the air.
Hormones – whether in pregnancy, menopause, or during the use of prescription birth control products, can cause changes in the moisture content of your eyes.
The Solution: eye drops (either OTC or Rx)
Presbyopia = old or elderly vision
Presby = elders
Presbyterian church = the church’s decision-maker was a group of people called Elders
This seems to happen somewhere around age 40. The lens of your eye loses some of its flexibility. The lens has to be really curved to see up close, and then flattens out a bit to see far away. So, if the flexibility decreases, it means it can’t curve up enough to clearly see things up close.
The solution: wear reading glasses.
Stye = infected oil duct or hair follicle. Looks like a zit
**DO NOT TRY TO POP A STYE LIKE A ZIT!!**
They will usually clear out on their own in 6-7 days. Not too troublesome other than being sore, swollen, and not pleasant to look at.
The Solution: warm compress for 15-20 min, then take a shower or wash your face, then leave it alone! Can use drops or an ointment to help lubricate the eye. Worst cases will require antibiotic drops or ointment from the doctor.
Corneal dystrophy = a genetic condition that causes the accumulation of protein material build up in the layers of the cornea (recap: cornea = the very front layer of your eye that starts to focus the light into the eye). If this fluid gets cloudy with junk, then your vision gets blurry. No other symptoms really except worsening vision. A surgical procedure can be used to clear out the cloudy liquid, but no cure.
This can lead to corneal erosion (where the layers of the cornea begin to separate = painful). Corneal erosion has to be corrected by surgery. Erosion can also be a result of eye injury – either instant trauma or more gradual like an unhealed corneal abrasion (which can lead to ulceration and eventually erosion).
Take care of your eyes and treat them nicely!
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
If something happens to your eyes that makes you want to ask the pharmacist if you should go to the doctor, the answer will most likely be “yes, go see a doctor.” Even at emergency rooms, they will treat you and make you comfortable but always tell you to follow up with your eye doctor.
Photopsias = seeing things that aren’t really there, the visual cortex translates other sensations as “sight”
Floaters – “shadows” that float around in your field of vision. They *can* be a sign of a detaching retina, but that is usually not the case. They are normal for most people.
Inside your eyeball is a gel, called vitreous gel. Throughout your life, that gel begins to liquify. As it turns to liquid, it may have other bits of gel still floating in that liquid. And you see “shadows” because they block light from reaching your retina. Floaters may worsen with dehydration or exhaustion. If you try to focus on them, they “float” away.
Flashes – “seeing stars” – when the vitreous gel/liquid combo gets shook up and sloshed around (i.e. head trauma). You can also get “flashes” with Digitalis toxicity (Digoxin is a medication derived from the Foxglove plant and developed for arrhythmias.) This is a medication that the doctor will test your levels for to make sure toxicity doesn’t happen.
Waves = looks like radiating heat; caused by spasms of the blood vessels in your eyes. This may be one explanation of the “aura” that comes before a migraine. If it happens and no headache follows, it’s caused an “ocular migraine”.
Glaucoma = 2nd leading cause of blindness in the US and around the world; increased pressure in your eyes. The fluid around the eyes typically have adequate drainage so nutrients can flow in and waste can flow out. If that drainage becomes inadequate, the pressure builds up and it can put pressure on the optic nerve (the nerve that connects from the retina to the brain). It starts with decreasing peripheral vision, and can become “tunnel vision” where a person can only see right in the middle of their field of vision. Medications are eye drops that control pressure and help open up drainage pathways as much as possible.
(Macular Degeneration is the #1 cause of blindness in the US, Cataract is the #1 cause of blindness worldwide). It doesn’t hurt, and it takes a while for the decreased peripheral vision to be noticeable. It’s not reversible, but it can be slowed with medication.
Eye doctors have a way to check the pressure in your eyes each time you get your eyes checked.
Nystagmus (Nigh-stag-mus) = involuntary rapid eye movement side to side. Caused by a neurological issue – either related to the eye muscles and nerves or the inner ear (one cause a vertigo). The shaking seems to be worse when a person looks straight at something or someone. For someone dealing with nystagmus, they usually discover they can tilt or turn their head to make their eyes slightly off center where the shaking wills stop – this is called a “null point”. Strengthening eye muscles can help the shaking, but it still worsens with exhaustion or stress.
This can be a result of a stroke, multiple sclerosis (autoimmune). Dilantin is a medication for seizures, and is another medication that has to be regularly measured because too much can cause temporary nystagmus.
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Color blindness = blind to color
But it doesn’t mean that someone sees the world in black and white.
It’s technically labeled as Red-Green color blindness, which means the world is seen in shades of yellow.
The cones in your eyes (a certain shaped cells in your retina) are built to pick up different wavelengths of light (think ROYGBV). So the cones that would pick up reds and greens are absent or broken.
Found to be a Y-chromosome trait, so it is more prevalent in males.
Rarely Blue-yellow color blindness is a thing.
conjunctivitis = pink eye = inflammation of the conjunctiva
conjunctiva = the layer that covers your whole eye
3 types:
– Viral – , itching, watering, burning, light sensitivity, very contagious, lasts ~ 7 days
– Bacterial – green/brown discharge (aka “goo”), foreign-body sensation, contagious, can cause damage if untreated, requires antibiotic drop
-Allergic – triggered by allergens, histamine reaction, can accompany a larger, more general allergy reaction, anti-histamine eye drops can help
Corneal abrasion = scratched or injured cornea
Symptoms: redness, watering, light sensitivity, foreign-body sensation
Can be dramatic or traumatic like being hit in the face or eye by something, or something as simple as rubbing an itchy eye or getting something out of their eye.
* If you end up with something in your eye, the best option is to flush it out with water or saline
Bacteria on your hands or the thing that scratched your eye can lead to a deeper infection, but most of the time, if you use caution, it will heal itself rather quickly.
**Solution for light sensitivity: wear sunglasses at night
Detached retina = when the retina detaches from the back of the eye
*Sounds awful but it doesn’t hurt
Retina – a web of nerves in the back of your eye that sends signals to the brain
Closing curtain sensation = part of the view of vision will become shadowed as the retina detaches gradually from one side to the other. Floaters also show up if this is happening. (All floaters ARE NOT related to the retina.)
Sudden detachment can be caused by head injuries or sudden intra-ocular pressure drops (the fluid pressure inside your eyeball). This sudden detachment is experienced as a flash of light and then sudden darkness.
Sudden or gradual detachment requires immediate medical attention and can be repaired with surgery and medical intervention.
Diabetic retinopathy do to chronic damage can lead to retina detachment.
*The risk of retina detachment occurring after an eye procedure (lasik surgery or cataracts surgery) is skewed for people with severe nearsightedness, possibly due to a genetic disposition of having a shorter retina.
Question: Safe to use allergy eye drops long-term?
Answer: Sure! The only problem is that chronic use can lead to your body not responding to the same med over and over as well. So, to avoid this, swap between drops and allergy tabs – based on if you’re experiencing “eye only” allergies or a wider allergy response that involves the sinuses too.
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Your eyes work together so that the line of focus for each eye cross, and that is your most in focus image. So as your eyes make tiny adjustments, you can focus on things close up or far away.
If you have a lazy eye, the muscles don’t allow the eye to focus and coordinate with the strong eye. This can lead to double vision or blurry vision.
Abmlyopia – I remember it because it sounds like “ambling” which can mean to meander or wander around. Versions of this can be caused by torticollis, where a baby’s head is tilted or twisted due to positioning in the womb. The eye can either compensate for the difference or it’ll just give up and let the dominant eye do all the work. Correction of this issue usually involves patching the strong eye and making the weak eye do all the work. The blurry or double vision can lead to headaches. Overuse and fatigue (like long days at work) can make it worse.
Astigmatism = irregularly-shaped cornea (not a stigmatism). I think baseball vs football. A circular lens (baseball) focuses light to a single point. A football-shaped lens focuses light to a line, so that makes the vision blurry. This is why people with astigmatism will squint. Squinting is a way for your eyes to manipulate the amount of light coming in and alter the shape of the eye to clear up the image of what they’re looking at.
Lasix procedures can correct astigmatism – the laser does micro-damage to the eye and it heals more circular in the eye.
Blepharitis – inflammation of eye lids. Can result in dry eye.
It can affect the outside (eye lashes side) or the inside (lubrication gland size). This is NOT a stye. Caused by a chronic build-up of bacteria, skin flakes, dried eye lubrication.
Some skin conditions can make a person more susceptible to blepharitis – Rosacea (overgrowth of skin bacteria), severe dermatitis, including psoriasis. It’s recommended to use really good eye hygiene before having a doctor intervene. Using warm compresses to keep dried skin and “eye crusties” soft and glands open so they don’t get clogged. Using clean cotton swabs or clothes instead of your hands to touch or wipe things out of your eyes, so you don’t transfer bacteria. Doctor’s can insert a catheter into the tear ducts to keep it open and less likely to keep it clogged. There’s not a cure to make it go away for good.
Cataracts – the lens of the eye gets cloudy due to proteins clumping up. People have described trying to see with cataracts like trying to look through wax paper. Risk of cataracts normally increases with age. The risk for cataracts can be increased even more by chronic diseases (diabetes, high blood pressure), poor health habits (obesity, smoking, alcohol use), long-term use of certain medications (steroids, hormone replacement therapy). The current treatment for cataracts is lens replacement. The old treatment would be just removing the proteins, but depending on a person’s longevity, they may get cataracts again in their lifetime.
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Your eyes are more complex than any camera on the planet!
Cornea – a concave lens on the front of your eye that focuses light
Iris – the colored part, a diaphragm that controls how much light comes in (the pupil is the hole the light enters = equivalent to the aperture of a camera)
Lens – the “focuser”, uses a process called accommodation to focus near to far and make the image as sharp and clear as possible
Retina – the sensor, and sends signals to the brain to translate light into an images
The retina has 2 types of sensors:
– Rods – detect light intensity
– Cones – color differentiation
Two special areas of the retina:
– Macula – right in the middle of the retina, they place that detects the most detail (that’s why the center of your vision field is a clearer picture than the periphery)
– Fovea – the center of the macula, it contains cones (color sensors) only to aid in the translation of very fine details
Support structures
– Extra-ocular muscles – allows your eyes to move around in their holes
– there are chambers of fluid that are between each structure of the eye, and that fluid helps hold nutrients that feed those parts, and remove waste
– Choroid – the layer that holds all the blood vessels that feed the eyes
– Sclera – the whites of your eyes, an outer coating that hold everything inside
– Conjuntiva – the mucus membrane that attaches the sclera to the eyelids; produces liquid for lubrication and trapping invaders
PSA: Please don’t vigorously rub or scratch your eyes, you could hurt them!
Support us on Patreon
*NEW* Join the Pharmacist Answers Podcast Community on Facebook
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Your brainstem is the most basic area of the brain. The area of the brain that we have in common with almost all other levels of the animal kingdom. It extends right into the spinal cord. A lot of other whole body involuntary reflexes come from the spinal cord – that’s another story for another day).
3 main parts:
– Medulla oblongata – rhythm center (heart rate, breathing, swallowing, vomiting and coughing reflex) – they’re all involuntary
– Pons (not ponds) – the bridge between the cerebellum hemispheres and other brain regions, helps coordinate the right side and left side of your body for complex activities
– Midbrain – sensory reflexes (also involuntary) – blinking, eye focusing, pupil dilation in response to light, visual and auditory startling reflex that kick-starts the “fight or flight cascade”.
Other eye focusing problems are not rooted in the midbrain, they are more likely rooted in the areas of the brain that control orbital muscles or in the areas that translate what your eyes are seeing. Things like a “lazy eye” or drifting eye, or being cross-eyed. There are therapies that doctors prescribe to try and strengthen the weak eye.
Blinking is usually a response to eye moisture.
Support us on Patreon
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Episode 80 – Blood Brain Barrier
The blood brain barrier is the last layer of cells between what’s in your blood and the extracellular fluid around your brain cells.
You’re born with it! It’s main job is filtration…
2 ways things get through the blood brain barrier:
– Passive diffusion: small, neutral molecules (water, gases, lipid-soluble)
– Active transport: glucose, amino acids, drugs (like a revolving door)
Permeability: how easily something can pass through a layer without work
Things that change permeability:
– Inflammation – stretches layer and makes holes bigger (meningitis, injury)
– Multiple sclerosis – an auto-immune disease that can degrade the BBB
– Alzheimer’s – BBB becomes overwhelmed with antibodies and burns out
*Scary Section*
Rabies – the virus is small and can get through the blood brain barrier but the immune system cells, antibodies from the vaccine, and medicines can’t
HIV encephalopathy – a mutation of HIV can get into the brain and use brain cells to replicate (rather than the well-known T-cells of the immune system). There is also a rare symptom of HIV called HIV-associated dementia
Pregnancy causes the permeability of many areas of the body to change, and this includes the BBB (callback: microchimerisms)
Drugs that have central nervous system effects (good) or side effects (bad) cross the BBB.
So test yourself – use what you know of different medications and what job they’re supposed to do and what negative side effects they cause and see if you can guess if they cross the BBB.
Support us on Patreon
Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio
“Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/
Pharmacist Answers 