Wednesday 4 January 2017

Myodesopsia and the #detective



 
Myodesopsia

I took my telescope outside one night and set it up on the patio, as normal, so that I could spend an hour or so checking out the night sky. Jupiter is always worth studying and a clear cloudless night was an excellent time. And the Plough occupied a great position just above the tree line.


As I closed the door behind me a rush of fear invaded my soul when a shaft of light abruptly penetrated my eyesight. Within moments everywhere I looked my eyes picked up a sudden flash of light that resembled a lightning strike. I did what anyone else would do I suppose. I shook my head, squinted my eyes, rubbed them, and waited for normal service to resume as soon as possible. But the lightning strikes persisted and I was conscious of a flash appearing in the corner of my eye every couple of seconds. The flashes became more prevalent and when I closed my eyes all I could see was a television screen complete with static.
Actually, what I could really see behind my eyelids was total blackout interspersed by the odd flash of light at the sides accompanied by a handful of cobwebs moving slowly across the centre of my vision. When I returned indoors the lightning strikes stopped but the cobwebs and stuff floating in front of my eyes continued. It was quite worrying and for a moment I wondered what the hell was going on. It was that awkward moment when something deep inside queries whether or not you might be in the process of losing your eyesight.
A visit to the doctors swiftly followed the next day and in no time at all I was referred to the local hospital to see a consultant. Indeed, a couple of eye drops later and I waited patiently to be seen by the ophthalmologist.


It took about half an hour for the eye drops to work and it was explained to me that the drops would open up the pupil so that the retina could be examined properly. It really boiled down to whether or not the retina had become detached. If that was the case, I would be in real trouble and my eyesight would be in question as serious eyesight deterioration could be expected.

In due course I took a seat behind a set of instruments designed to examine the eye in fine detail. ‘Look left, left right, look up, look down’ – ‘and then repeat with the other eye’,’ said the most important man in my life. ‘And again,’ as he shifted position and brought all his skills to bear.

Well, I love a work out in the gym but that was the best workout my eyeballs have ever had, I can tell you.
The medical expert then explained what he’d found and why he’d found it:-The thick fluid or gel that fills the eye is called the vitreous humour, or vitreous body. It’s a jelly-like, transparent substance that fills the majority of your eye and lies within a chamber behind the lens. It’s one of the four main optical components of your eye. When you are young, the vitreous is transparent, but as one ages, imperfections gradually develop. The common type of floater, which is present in most people’s eyes, is due to degenerative changes of the vitreous humour.

 The perception of floaters is known as myodesopsia. As people age, this vitreous becomes more and more liquefied. The vitreous has loose attachments to the retina, and more firm attachments to the optic nerve. At some point in a person's life, the vitreous liquefies enough to shift position in the eye. When this occurs, usually between age 50 and 70, the back edge of the vitreous will pull forward away from the retina, leading to a ‘vitreous detachment’. This is generally a normal process, although it may happen abnormally early in cases of near-sightedness or trauma. As the vitreous detaches, it tugs on the retina. This is perceived as a flash of light, similar to a lightning flash in the corner of the vision. It may occur especially with eye movement, since the vitreous moves in the eye. Debris pulled off of the optic nerve and retina are then seen as floaters, suspended in the vitreous above the retina. Sometimes this is described as a cobweb, a net, a string, or a fly over the vision. These symptoms usually resolve over a period of days to weeks, although some people will continue to see the floaters for a longer period of time. The important thing is to determine that the retina is healthy as the vitreous detaches. This requires a careful dilated examination of the retina to look for tears, or other areas which may be at risk for tearing. A retinal tear can then lead to retinal detachment, if not treated. 
Thus, people experiencing these symptoms should be examined by an ophthalmologist as soon as possible. About 1 in 10,000 cases of vitreous detachment lead to retinal detachment. While surgeries do exist to correct for severe cases of floaters, there are no medications available that can correct for this vitreous deterioration. Floaters are often caused by the normal ageing process and will usually disappear as the brain learns to ignore them. Looking up/down and left/right will cause the floaters to leave the direct field of vision as the vitreous humour swirls around due to the sudden movement.
So there you have it. My eyesight proved fine other than the deterioration discussed above. It’s part of the ageing process but it is also part of a learning curve if such a thing has never happened to you before. My retina had not become detached and after a month or thereabouts the floaters and flashes disappeared as my brain accepted them and adjusted accordingly. I get a slight attack of flashes at night, now and again, but that’s usually under a street light and I’ve learnt to live with it.
Well, thought I, now I have a story to tell. So, without further ado, I introduced myodesopsia to my fictional detective Davies King. I think they call it character development or whatever. I call it storytelling. Here and there, Davies King takes on a criminal or two. But can you imagine how difficult that might be in the early stages of myodesopsia – particularly when the hero has no idea of what is happening to his eyesight or what to do about it. It’s another problem to deal with. Is that why he doesn’t win all his cases?
Myodesopsia – detail apart, if you experience any of the symptoms described above get down to see the doctor pronto. Get it checked out as soon as you can. You won’t regret it. The problem for many is – they just don’t have the time. Make the time before it’s too late.
Check out the Davies King detective series..... The main character suffers from this condition..... 
The Conchenta Conundrum, Moonlight Shadows, Behead the Serpent, and Breakwater.... Thank you
Click on Paul Anthony for his website and links to  Kindle and print copies