His Eyes Doth Protrude Too Much

A tip o’ the lid to my friend Jason who yesterday beat me to the punch and blogged on a matter of utmost ocular importance.

During Sunday’s AFC Championship game between New England and Indianapolis, it seems much that much of the country’s attention was focused on Patriot wide receiver Reche Caldwell and his prominent peepers. Nicknamed “Headlights” by his teammates, Caldwell has eyes that appeared to nearly pop out of their sockets several times during the game, especially those two times he dropped easy catches, one all alone in the end zone. Rodney Dangerfield would have been proud–and impressed.

In blogs and news reports across this great land, the American people spoke with one voice: His eyes doth protrude too much. The question remains: Why?

Well, let me break it down for you so that even an Auburn grad could understand:

1) First off, it’s very common for African Americans to have prominent-appearing, large eyes due to their natural, shallow bony orbits. In fact, Reche, who played for Florida, has a brother Andre who is also a receiver for the Gators and shares the same appearance. I encounter this several times a week in my practice, and while it gets your attention, after a while it just becomes background noise if you’re an eyeguy like me.

2) My friend Laura, who is a nurse, but no Nurse Nazi unless you really push her, brought up the point of thyroid disease at Jason’s blog. Exophthalmos (that’s “bug-eyed” for you manure shovelers) is certainly on the differential diagnosis list, but as I pointed out to her, people with thyroid problems tend to have the sclera (War Eagle people, that’s “whites of the eye”) prominently displayed at all times. In Caldwell’s case, his press photo shows a more or less normal appearance. Plus, during the game, the bulging appearance was intermittent (Barners, that means “evra’ now and then”).

3) It is also possible that Caldwell was so surprised at having dropped those two balls that his lids parted widely from a sympathetic nervous system response (“fight or flight” reaction). However, such reactions are totally automatic, and he instead seemed to be controlling the response; my clinical opinion is that it was more likely an attempt to compensate for blurry vision.

4) Although I cannot be 100% sure, I’m betting that Caldwell wears toric, astigmatism-correcting contact lenses. One possibility is that he was trying to reduce his blink rate in order to keep the contact lens stable on his eyes (toric lenses rotate when you blink, sometimes producing blurry vision until the lens settles again). If you recall, Mark McGuire used to stare widely and his eyes seemed to bulge in those milliseconds prior to swinging at a pitch. No, it wasn’t the ‘roids; McGuire wore toric contact lenses.

5) Another contact lens scenario has the lenses drying out too much. When the eyes dry out for any reason, many times there is a paradoxical (Cow College people, that means “the opposite of what you would think”) reflex tearing which floods the ocular surface with soothing relief. One way to compensate for contact lens-induced dryness is to stare widely and then blink hard to produce reflex tearing which gives a few seconds of relief and clear vision.

Whatever the reason, Caldwell’s eye ailment could have been properly addressed by a timely visit to an eye care professional, perhaps an optometrist who could have prescribed a properly fitting contact lens and treated his dry eye, or an ophthalmologist who could perhaps have performed LASIK and gotten rid of his contacts altogether. In the case of the Patriots, they have no excuse since they have the very fine New England College of Optometry right there in their own backyard.

The moral of the story is this: if your eyes doth protrude too much, go see your friendly neighborhood optometrist. After all, you never know what you may be missing. In the case of Caldwell and the Patriots, it may have been a trip to the Super Bowl.

  1. Ed

    We plan on taking full advantage of our new vision insurance this year … and our eyes don’t bulge … much … some …

  2. Mike the Eyeguy

    Ed, I’m glad to hear that. Your arms can only stretch out so far, after all.

  3. lAURA

    Well, I will have to say Dr. Mike I think you are right. That is the first time I had ever seen this guy and to look at other pictures he def. does not have bug eyes all the time. I know he is kicking himself now for not having them checked. Oh well, it was good for us colts fans. FYI; we had a patient come into the office this past year and was diagnosed with Graves Disease but she presented with unilateral exopthalmos. It was very unusual. You have probably seen this before though. Have a good week.

  4. Mike the Eyeguy

    Yes, exophthalmos can be asymmetrical. All the more reason to do an MRI of the orbit to rule out retrobulbar mass.

    Are we having fun yet people?

  5. Terri

    Thanks… I was strugglin’. You know in general healthcare marketing – we don’t deal with you optical people all that much.

    Hmmm… I have a little bit of thyroid trouble myself. I do have those big ol’ cow eyes as my brother is so fond of reminding me.

    Did I say, “War Eagle”?

  6. Mike the Eyeguy

    “Did I say, ‘War Eagle’?”

    Just had to get that in there, didn’t you.

    Tell that brother of yours to go get his eyes examined.

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