I’ve received quite a few compliments on my “old-timey” eye exam header at the top of my blog. Glad y’all like it. I think it symbolizes what I’ve been trying to do here at Ocular Fusion over the years (“Just looking around and trying to put it all together”).
That, plus I like black and white, old school pictures. We’ve had a blast going through Mom’s pictures since she died and found some real gems. It’s always good to be remember your roots.
Of course, any eye-savvy folks out there can immediately spot the irony: Old Timey Eyeguy is not really “fusing.” He’s doing what’s called “monocular indirect ophthalmoscopy” (MIO) as opposed to “binocular indirect ophthalmoscopy” (BIO) which is what we modern eye docs typically do. That’s the preferred method because if you use those eye drops that blow your pupils wide open for several days and make your life miserable (it’s really only a few hours, just seems like days) you get a nice 3D image with BIO. Like they always say, “two eyes are better than one.”
Two eyes are better than one because when they work together you get your money’s worth after plopping down $15 for James Cameron’s Avatar at the movie theater with the leather seats and the wine bar. I feel sorry for the poor saps with one functioning eye who handed over their hard-earned cash and eagerly put on their 3D glasses for what was billed as “alternate reality, complete immersion experience” only to discover that Pandora is flatter than one of those 14th century maps of planet Earth.
The problem for us eye doctors is that it’s not always possible to do BIO. There are some situations where only MIO will do. Like this Saturday when I do that eye screening at the health fair. I won’t have the luxury of dilating pupils, and I’d like to do at least a little something to let the patient know what is going in their retina beyond donning a turban and trying to channel Carnac the Magnificent.
But I have a confession. I tried to do MIO like Old Timey Eyeguy yesterday and I couldn’t. I took my direct ophthalmoscope (DO) and my 20 diopter condensing lens (the kind you used to fry ants with when you were a kid) and kindly ordered my tech to sit for me as a practice patient.
I caught a few fleeting glimpses of the optic nerve now and then, but it was hard to get everything lined up and focus on that spot in the picture where all the little light rays cross in midair. Without a dilated pupil, it was a little like sticking a straw through the keyhole of a door and trying to find out what is going in the next room. After my tech started squirming in the chair and I started to pick up the scent of his freshly-fried retina, I finally gave up. Obviously, I’m a little rusty.
Now I know what you’re thinking: Why don’t you just use your DO alone? Well, DUH. To do that through an undilated pupil you’ve got to get within millimeters of the patient’s face. There are a thousand and one reasons why this is not a good idea. The thousand being all the different viruses floating around out there this time of year, not the least of which is the Razorback Flu, and the one being personal hygiene or the lack thereof. And, no, I’m not talking about mine.
Gentle Fusioneers, here’s a hot tip for you: As you get older, don’t forget to take a bath. You will feel as though you don’t have to bathe as often, but believe me, you do. Just because your spouse or your buddies down at the Senior Center don’t care about your BO (probably because they haven’t bathed in 3 days either and you all cancel each other out) doesn’t mean that other people don’t.
Like your eye doctor who is trying to screen your eyes through an undilated pupil and can’t use BIO, can’t remember how to do MIO, and doesn’t want to do DO because of your BO.
OME, OMY, I can’t find the eye. That’s an embarrassing admission for an Eyeguy like me.
But there may be light at the end of the tunnel. We could pass the collection plate and buy me one of these bad boys (“Fast, easy entry into undilated pupils! Greater working distance increases comfort for both practitioner and patient!”).
FedEx delivers overnight, people. I’ll have a PayPal button up ASAP.