Eye Didn't Know!

How the Eye Works

Did you know?  The average person has almost no idea how the eye works! When educating patients about their eye conditions, I routinely start from square one, and give them a quick overview of how the eye works. The simplest and most accurate explanation is that the eye is like a camera.

Light enters the camera through its lens, is inverted, and lands on the film (or digital sensor), where it can be processed into a picture.

Similarly, light enter the eye through the cornea (the clear window) and passes through the lens, where it is inverted. The light then lands on the retina, which is like the film in the camera. The signals from the retina travel through the optic nerve to the brain, where they are processed into a picture.

(image courtesy of the American Academy of Ophthalmology, with permission)

Did you also know? The pupil of the eye is like the aperture of the lens. In dim light, a photographer opens the aperture wider, letting more light in. Similarly, the pupil enlarges in dim light, letting more light in. In dim light, the photographer will choose a more sensitive film (or increase the sensitivity of the sensor). Similarly, the retina gradually adapts to dim light by becoming more sensitive to light (think of walking into a dim movie theater.)

So, are your eyes Nikon or Canon?

Using Eyedrops

Did you know? Patients are routinely prescribed eyedrops for a variety of conditions, including dry eye, infections, glaucoma, and for post-operative care. Few patients, however, are given instructions on how to instill their eyedrops. When asked to demonstrate how they instill their drops, few patients are able to perform drop administration reliably, which means that they may be receiving inadequate medicine, or may be spending too much on drops because the drops don't enter the eye on first attempt.

The sketch below shows proper technique. One stands in front of the mirror, pulls the lower lid down, and places one drop into the pocket formed. The drop does not need to be placed on the eyeball, and one drop is all that is necessary.

That's all there is to it!

(image courtesy of American Academy of Ophthalmology)

Did you also know? Closing the eyes gently for a minute or two after drop instillation may help increase its absorption into the eyes and keeping the medication out of the bloodstream.

Health Care Costs

Did you know? Imagine a restaurant where you don't pay for your food. Everyone else in the restaurant pays your bill. Imagine that none of the other diners pay for their food. You, and everyone else pay for their meal. Do a thought experiment as to what would happen to expenses at this restaurant. 

With everyone else paying for your food, you would likely indulge in the finest, most expensive food on the menu. As would everyone else at the restaurant. The restaurant would keep raising prices, as demand would keep rising. If all restaurants were forced to operate in this way, costs would explode, and dining would assume a greater and greater share of the nation's economy.

Do the same thought experiment with haircuts. Housing. Automobiles. Computers. Televisions. It is obvious that costs would rise in each situation.

Medical Care.

Oops, that situation today exists for most medical care.

Two historical events provided the incentives for this situation. In World War II, wage and price controls (never a good idea) were imposed. Employers wanted to reward their employees in other ways, so the government mandated that health insurance could be provided tax-free. Thus began the link between employment and insurance, and the incentive for insurance to become bloated, providing for more than just catastrophic illnesses and accidents, like insurance was designed to do.

Second, Medicare and Medicaid were started in the 1960s to provide "free" health care for seniors and the poor, thus creating the situation like the restaurant above. 

John Stossel, as usual, hits the nail on the head in this excellent video:

For a way out of this mess, John Mackey, president of Whole Foods Markets, provides these clear, economically sound solutions.