• Daniel Laughlin

Taking my Mom for an Eye Exam.

When I lived full time with my parents in Victoria, British Columbia I worked at an optometry practice downtown. She gratefully agreed to be my guinea pig for an afternoon while I messed around with her eyes for an hour or so.

My mom has a POH of a horseshoe tear in her right eye, big problems with dry eyes, and has worn PALS with a small hyperopic Rx w/ ~ -2.25 cyls either eye for about 15 years.

The biggest reason I wanted to bring her in was to photograph her horse shoe tear scar in her right eye. I dilated her with Mydriacyl and it didn't take long to find the scar tissue on the retina. I had her look in all directions of gaze, and saw something pretty abnormal in the superotemporal retina. At first I thought it was bear tracks or some kind of congenital pigment issue because I had never seen a live scar on a retina before. It was also a lot bigger than I expected - approx. 2mm just comparing it to the optic disc with a 66D Volk lens.

Bear Tracks from

Columbia University.

Here is the best photo I got of the scar from her HST. I took it with my Iphone and a Magnifi slit lamp attachment. It took a while to keep a steady image - eventually got one with a Digital Wide Field lens.

Scar tissue on superotemporal retina from laser retinopexy on HST that is approx. 6 years old.

I got a few more photos just for fun of her disc. I also have one of my initial view when I thought it looked like bear tracks.

Her distance vision seemed to be doing okay, but was having some problems reading. She is 65 and has the beginning of a cataract in her right eye - probably because of the previous retinal surgery in that eye. This cataract was causing a hyperopic shift in one eyes which became troublesome while reading (something I missed while refracting her - but my boss did her exam later and caught it). I originally checked prescribed her Add binocularly as you normally do, but my boss caught the problem and prescribed different adds in either eye. He decided it was best to just get a separate pair of reading glasses made up for long term near use with a different add in each eye.

My mom also has a huge problem with dry eyes that water extremely badly during the day. I did a Jones 1 test to check the nasolacrimal drainage for age related stenosis - but it looked pretty clear after I left the Fluorescein for 5 minutes. Fluorescein and 5 #KMK.

She has a few blocked meibomian glands, mild blepharitis, but gets really irritated eyes during the day.

So we are gonna put her on a trident of gel gtts at night, ultra throughout the day every few hours, and some sort of homemade Eye Bag concoction with lid wipe use at night. We will order some lid wipes online, but couldn't find any nearby. Hopefully this susses out the problem once and for all!

My mom has had a few previous bouts of basal cell carcinoma around her eyes. The use of sunscreen and sunglasses was not as well advertised when she was growing up!!! She basically just has to get them excised every time they begin to pop up again.

The first image is from skincancer.org, showing a small pearly lesion on centre of the bottom lid. The second is a picture (kinda hard to make out) of one of the scars she has had from getting the lesions excised.

She has a few small things to watch out for like recurring tears, handle the DES better and watching out for new lesions. But other than that, hopefully I will get to see her enough to get some great shots of it all!

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