Iridology Uncovered

Did you know an extensive branch of alternative medicine is based on the interpretation of nooks and crannies in the iris?  It is called iridology, and has amassed a considerable cultish following.  Iridologists believe that alterations in iris texture, color, and structure can portend imminent changes in one's physical, mental, and spiritual well-being.  Much like augors who read the future in the entrails of sacrificial animals or coffee dregs, iridologists claim to portend "tissue weaknesses, inflammation or toxicity in organs or tissues". They use magnifying loops and a penlight (sometimes a video camera) to document their findings, while referring to iris maps such as this one, originally developed by Bernard Jensen in 1981 (from http://www.truevitality.com.au/wp-content/uploads/2009/08/iridology-eyechart.jpg)

Although I like to give everyone the benefit of the doubt, even when it comes to quacks, I came upon an interesting site entitled "Confessions of a Former Iridologist"  that convinced me otherwise (http://www.quackwatch.org/01QuackeryRelatedTopics/confessions.html).  Mr. Mather is a recovering iridologist who expresses dissenting views (infidel!) on the profession he once held at high esteem. His apprenticeship in western medicine and appreciation for evidence-based proof led him to re-examine the field using controlled conditions. He concluded that "not only did the light placement affect the appearance of structures; the slow draining of the batteries in the penlight changed the appearance of the eye color" and that iridology, therefore, has "no basis in real anatomy and physiology and . . . failed well-done trials and studies."  Still, the Iridology charts would make for cool coasters.



http://www.herbsbylisa.com/iridology.html http://www.truevitality.com.au/wp-content/uploads/2009/08/iridology-eyechart.jpg

Twitch Hunt

We all experience the lid twitch every now and then.  The upper or lower eyelid begins to intermittently spasm, and it seems the whole world can see it.  "I look like I have Tourette's," we think to ourselves.  In fact eyelid twitch, also known as eyelid myokymia, is almost imperceptible to others.  At least once a week, I see a handful of patients who rush in because their eyelids are doing the lambada.  If severe enough, eyelid myokymia may cause your world to seemingly bounce up and down as well (oscillopsia).

Why does this happen?  Essentially, the orbicularis muscle of the eye (in charge of opening and closing your eyelids) contracts rapidly in response to misbehaving nerves.  This usually occurs intermittently for a period of days, weeks, or even months.  Although extremely irritating, eyelid myokymia is benign (but if it lasts more than three months, call your eye doc).  It is triggered by such quotidian factors as inadequate sleep, fatigue, excessive caffeine, and emotional stress or anger.

Do you live in a large metropolitan area?  Do you down a grande latte mocaccino in your way to work?  Are you employed by the mafia or the CIA?  Or, are you leading a covert double-life and secretly hording a second family in Pennsylvania?  If you answered yes to any of the above, the lid twitch can happen to you at any moment.  Although there is no medicinal cure for it, eyelid myokymia improves with a good night's sleep, relaxation, and positive thinking.  Try to chillax with a glass of wine and a good Ingmar Bergman movie, or read the Seven Habits of Highly Effective People -- if nothing else it will help put you to sleep.


Walsh and Hoyt's clinical neuro-ophthalmology By Neil R. Miller, Frank Burton Walsh, William Fletcher Hoyt. 6th edition. Page 1216.

White Cadillacs

Cataracts, the bread and butter of ophthalmic surgery, are often referred to by the old folks as "Cadillacs."  That's fine by me, because there are about as many types of cataracts as there are Cadillacs: white, black, brown, front-loaded, back-loaded, with spikes on the sides. . . Unlike Cadillacs, though, cataracts never went out of style.  Everyone gets cataracts at some point, if s/he lives long enough.

Cataracts are opacified lenses.  Like a camera, your eye has a lens that sits in a bag ("capsule") behind the iris.  All your life, it works hard, changing shape to focus near and far objects, allow color and light to come through, and filter UV rays.  When you turn forty, the lens gets a little rusty and starts having difficulty focusing at near (like an old tire, it looses its flexibility).  And then, sometime after that  -- there is a sixty year range -- the lens begins to cloud up and transmit vision poorly.  Color vision is diminished (blues and greens take on a yellow-orange tinge), objects appear fuzzier, and people experience more glare.  Chemically speaking, the proteins in the lens morph into water-insoluble molecules and the lens medium becomes opaque.  Time to take it to the shop and trade it in for a new one!

In cataract surgery, we use tiny instruments, some ultrasound power, and a little pump to remove the old cataract.  Then we replace it with a shiny new lens implant that we place in the same bag that once held the cataract.  Of course, there are different models.  The standard government issued lens implants give you good vision at one specified distance (near or far).  The suped-up ones ("premium lenses") give you good vision at near and far, decrease night glare, or correct for astigmatism.  They do not come with heated seats, but you can get ones with tinted windows (the SN series by Alcon) and others that decrease the blurry vision you may get at night.  Of course, you should read the small print (or if you can't see small print anymore, get a magnifier), and make sure you understand the side-effects associated with the premium lenses (glare, cost, decreased contrast).

Being the most commonly performed surgery in America today, cataract extraction is now perfected to an art-form.  It can be done suturelessly, painlessly, and rapidly.  And we throw in an oil change.