Monday, August 2, 2010

Mystery Medical Mondays: Eyes

So do you ever wondered what your PA, doctor, or NP sees when they look in your eye with that really bright light?

Every Monday I'm going to post about interesting random facts that your doctor, PA, or NP knows but you most likely don't. As a PA it is my duty to educate the public--so this is apart of my contribution!

There are a few things every practitioner should be looking for when they exam your eye.
- pupil size and reactive to light an accommodation
- red reflex
- fundascopic exam

This is the bright light your practitioner comes at you with is called a ophthalmascope, it looks like this:
picture borrowed from here

Pupil size
- Your pupils are the "black" part in the center of your eye. If you are in bright light, your pupil will constrict or shrink to protect the delicate structures in the back of the eye. If you are in low light your pupils expand to allow more light to get in.

Reactive to Light and accommodation
- If you shine a light in one of your eyes, both of your pupils will contstrict--why you ask? Its all because the way your optic nerves travel through your brain. They partially cross each other in the optic chasm right above your pituitary gland. image borrowed from here

Red Reflex
- This is that pesky red-eye part of pictures everyone hates. There is an actual important use seeing this "red reflex." Absence of a red reflex may indicate retinoblastoma, this is a cancer of the eye that can be random or hereditary, it occurs mostly  in children under 10. You can see that this child has a proper red reflex in the child's right eye, but no red reflex in the left eye. This child most likely has retinoblastoma.

picture borrowed from here

So next time you take a picture and someone's eyes look red like the devil, just let them know that they have a healthy red reflex!!

Fundascopic exam
 The fundus is the back inside surface of your eye. 
This is a "normal" fundus of the left eye. The most important parts for a practitioner to exam in is the optic disc, optic cup, blood vessels, and the macula. 

picture borrowed from here
The optic disc and cup is where the optic nerve and blood vessels enter the back of the eye. This is your "blind spot" but our brains are very awesome, because it intprets this blinds spot and 'patches' it for you, so your are usually not aware of it. If you have hypertension (high blood pressure) your optic disc and cup will look abnormal, it is one of the first places in your body affected by high blood pressure. 

The macula is the spot in your eye that is the most accurate, where the majority of your rods and cones (the cells that sense color, and light). This is also the most sensitive part of your fundus--when the practitioner shines the light and it hits the macula you will feel some acute pain and you will want to move away.   Macular degeneration is a condition in which your macula starts to degrade, and you have a hard time seeing shades of colors, and your ability to see small things will diminish. 

Blood vessels in your eye can also tell your practitioner a lot about your health. If you have diabetes that you aren't controlling then you may have micro-hemorrhages (small blood vessels that burst and bleed a little- like a bruise). Also you may have thickening of your blood vessels which over time can  severely cause problems with your vision- this is caused by hypertension, atherosclerosis, and diabetes.

So next time your practitioner looks in your eyes you can say "how's my fundus look?" and I bet your practitioner will be surprised!

Thanks for stopping by! Come back next Monday for the Mystery Medical topic of the week!!

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