Episode 87 - Eye Conditions 3

The Pharmacist Answers Podcast

Eye Conditions in (not) ABC Order

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

This is 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

It is the 2nd leading cause of blindness in the US and around the world. Glaucoma is known for 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. 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.

(Macular Degeneration is the #1 cause of blindness in the US, Cataract is the #1 cause of blindness worldwide).

Nystagmus

Pronounced nigh-stag-mus. It is the 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.

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Music Credits: “Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/