DR. HOOK- Eye, eye: See a floater? Get help quick!

I tell my patients that Im naturally blond with blue eyes. I just color my hair black and put on brown contact lenses so I dont look like an albino Korean-American man. Why does it seem to me everyone in Hollywood wants to be blue-eyed and blond?

Eyes are supposed to be the window to the soul. When I use my ophthalmoscope to look into my patients eyes, sometimes they ask what I see. If they're sassy, I sometimes respond, 6-6-6. Hey, is your middle name Damien?

Otherwise, I tell them I'm just checking their optic nerve, the vessels going in and out, etc. You can tell from the fundus (the interior back of the eye) if someone has uncontrolled diabetes, hypertension, or some infections. So maybe the eye is the window to the soul?

Some people dont like to touch their souls. I have a couple of friends who wont wear contact lenses because the idea of putting something in their eyes is like Cross my heart, hope to die, stick a needle in my eye. What happens, though, if these people have a retinal detachment? Got blindness?

The retina is in the back of the interior eye and allows us to see. Light passes through the iris, refracts through the lens, and then hits the retina- which consists of many layers of nerve cells. When the most interior layer of the retina separates from outer layers, it's like pulling off Burt Reynolds' toupee attached with superglue. The nerve cells start to die from the lack of blood supply, and permanent vision loss can occur. Ergo, you need to see the ophthalmologist pronto to preserve your vision!

(By the way, since everybody gets this confused: an ophthalmologist is an MD who does surgery and prescribes meds. An optometrist has a different degree and does not do surgery or prescribe meds. Opticians make your glasses. Do boys make passes at opticians who make glasses?)

There are two types of retinal tears: rhegmatogenous (rhegma meaning "tear") and nonrhegmatogenous (caused by leakage beneath the retina, or vitreous traction on the retina).

The former are more common– a direct hole or tear in the retina. Posterior vitreous detachment tends to occur in people 50-75 years old because the vitreous, a clear gel-like structure in the back of the eye, starts to liquefy over the years. (Sounds like the Wicked Witch of the West, Im melting!)

Over a week and up to three months, the retina starts to detach. Traumatic retinal detachment occurs after– well–trauma to the eye. Lattice degeneration usually occurs in younger people with myopia (near-sighted, meaning you need glasses to see far away) due to thinning of the retina.

Nonrhegmatogenous retinal detachments occur in one of 10,000 people every year. Fifty-five percent of these cases occur in strongly myopic people (Lucky me! Im blind as a bat without my glasses). Tractional retinal detachment tends to occur in people with eye disease from poorly controlled diabetes. (Remember, diabetes is the #1 cause of blindness, and overweight/obese Americans are developing diabetes faster than people are buying iPods.)

Those with inflammatory medical conditions can have exudative retinal detachment.

Floaters, cobweb floaters, large housefly floaters, brief flashing lights, a shower of black spots, or gradual loss of peripheral vision are hallmarks that should lead you to the ophthalmologist ASAP. The sooner you treat a detachment, the more vision you will preserve.

We all have floaters from time to time. But if you start to have them all of a sudden and they wont go away, or there are a lot more than usual, see the doctor right away.

If you agree with me, you can say, Eye, Eye, Captain. Quick action can save your vision.