OME, OMY, I Can’t Find The Eye

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.

  1. laurie

    On a somewhat related note to the bathing thing, my nod to decency is that I never eat garlic or raw onions on a day when I’m going to teach.  (Gives me something to look forward to after class.) 

  2. Mike the Eyeguy

    And your TEFL students (I’m betting 50% of them anyway) yell “Gracias!”

    Do garlic and raw onions put more bend in your free kick or something?

  3. Hal

    I tried one of those POs, but didn’t have any better view with it than one of the old MIOs.  Too bad; we really could use something that would give us a decent view and still maintain a casual relationship with the patient.I wish that my patients knew that my examinations are extra speedy when they haven’t bathed since they received their DD214.  Do you suppose they would, in fact, bathe if they knew that.

  4. Kristi Sweeney

    Thanks for the explanation on why my boyfriend won’t take me to see Avatar.  The poor guy is blind in his right eye.  

  5. Mike the Eyeguy


    I’m really POed to hear that the PO doesn’t live up to the hype. It figures.

    Yes, those who haven’t bathed since their DD214 get the VW eye exam and not the Benz. That goes triple for those wearing the smell of whiskey and copious amounts of Old Spice. Especially at 8AM.

    And no, I doubt it would make a difference.

  6. Mike the Eyeguy


    They do make a 2D version of Avatar and it’s cheaper! Tell your bf that, and I bet he’ll take you.

  7. Kristi Sweeney

    Thanks Eyeguy.  If that’s the case though, then we can probably just wait for the dollar movie and then I can talk him into taking me for sushi.  Maybe.  Hopefully.

  8. Greg England

    Imagine your older patients are all from France! I rode the bus in Yosemite enough times with vacationers from France to know they don’t seem to EVER bathe, at any age.Can’t you make one of those bad boys with a paper towel tube, a magnifying glass (what you call a “20 diopter condensing lens”), and a small flashlight? I know it could be done on any given TV show.

  9. Mike the Eyeguy

    Whoa–carefree Europeans on holiday. I can’t compete with that.

    I think I saw them make a makeshift MIO on “Lost” once. Season III, I think.

  10. Mike the Eyeguy

    I would like to let everyone know that I survived the vision screening with the help of Eyegal and another OD friend of mine.

    All the people who passed through our screening were congenial, kind and CLEAN!! I even brushed my teeth, put on some deodorant and enough cologne, but not too much. I even managed to do DO on just about everybody!

    A good time was had by all. Wish you could have been there.

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