Sunday, August 7, 2011

Important research

Several people found my challenging case on Friday to be so idiotic as to defy belief.

However, the Science Marches on Department has kindly brought my attention to a similar case that actually got published in a medical journal!

Yes, folks, here is the story of a lady with visual loss. After a work up found no clear cause, they discovered they could fix the problem simply by holding up her eyelids with tape.

Unfortunately, the abstract doesn't clarify what kind of tape. How would masking vs. Scotch vs. duct tap compare for this? Clearly, more extensive studies are needed.
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24 comments:

  1. UnknownAugust 7, 2011 at 11:11 AM

    *speechless*

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  2. lbparkerAugust 7, 2011 at 11:23 AM

    They needed an MRI to figure out her eyelids were drooping too much?

    Her doctor couldn't SEE that?

    Yeeesh!

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  3. Neuroscience PhDAugust 7, 2011 at 11:35 AM

    What's the impact factor of Orbit? Somewhere between 0 and 1 if they publish stuff like this.

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  4. AnonymousAugust 7, 2011 at 11:36 AM

    (looks at comments above) Help this layperson, is that what the medical jargon means? Her eyelids were drooping too much?

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  5. Grumpy, M.D.August 7, 2011 at 11:37 AM

    Yep.

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  6. AnonymousAugust 7, 2011 at 12:30 PM

    Of course her doctor couldn't see that. He also suffers from eyelid ptosis.

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  7. AnonymousAugust 7, 2011 at 1:49 PM

    In all fairness, this is an important part of the neurologic examination.

    We saw a patient in clinic yesterday with "loss of peripheral vision" in his right temporal field secondary to suspected VZV reactivation. Fortunately, upon retraction of his swollen upper eyelid, his visual fields were full to confrontation.

    Maybe we shoulda rx'd some scotch tape!

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  8. CateAugust 7, 2011 at 2:26 PM

    wow. i swear, if the legit case report I just wrote up to submit to a journal doesn't get published after crap like this does... i'll be pissed.

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  9. AnonymousAugust 7, 2011 at 4:54 PM

    Maybe they should have made sure her eyes were completely open BEFORE the MRI...

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  10. AnonymousAugust 7, 2011 at 4:59 PM

    blepharoplasty. it works. it is safe. patients are happy.

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  11. medstudentitisAugust 7, 2011 at 5:55 PM

    I think this would be a good use for steri-strips, they last quite a long time.

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  12. JessieAugust 7, 2011 at 6:18 PM

    You know my late elderly Aunt was having vision problems because of drooping eyelids. However her doctor was not an idiot and they did an eye lift (plastic surgery) and solved the problem.

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  13. AnonymousAugust 7, 2011 at 8:48 PM

    That's like a person I saw once who was complaining of temporary blindness. This occurred while he was asleep he said.

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  14. AnonymousAugust 7, 2011 at 9:49 PM

    So the next paper the authors will publish will be about the same lady developing dry eye, treated by removing the tape so she can blink?

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  15. AnonymousAugust 7, 2011 at 11:02 PM

    OK I'm a layperson, but couldn't droopy eyelids be caused by something like Myasthenia Gravis or some other type of disease, or toxicity? Could botulism poisoning cause it, or is that double vision only? What if it had been something really serious?

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  16. UnknownAugust 8, 2011 at 12:05 AM

    anon: oh yes, visual loss can be a very serious matter, so we do work it up properly.

    Of course, -properly- implies some sense to the entire matter. Sense, such as making sure drooping eyelids, eyepatches, sleep, eyes-swollen-shut and so forth do not interfere with the assessment of acuity and visual field. Possibly before an MRI is ordered for *gasp* blindness.

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  17. cliffintokyoAugust 8, 2011 at 4:53 AM

    A real eye-opener!!!

    (Sorry, I couldn't resist!)

    Cliff

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  18. AnonymousAugust 8, 2011 at 11:40 AM

    My brother has benign idiopathic blepharospasm. He was blind until after the myomectomies, the neurectomies and the botox injections. Fortunately, after all that, he can control it w/ cyclobenzaprine. Sometimes it isn't all that easy to simply open one's eyes.

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  19. JessAugust 8, 2011 at 2:18 PM

    I'll go with duct tape. It fixed my truck; it will hold eyelids in place.

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  20. Carroll Brown PA-CAugust 8, 2011 at 4:05 PM

    I once treated a young man who complained that he woke up with double vision. Astute diagnostician that I am, I noticed that his glasses were canted on his nose at about 30 degrees. I had him remove his glasses and his diplopia resolved.

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  21. PackerAugust 8, 2011 at 4:17 PM

    No lie, I can see my eyelashes and they bug the crap out of me, can't understand the women with the eyelashes that look like tarantulas on their faces.

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  22. RehabRNAugust 8, 2011 at 9:21 PM

    Grumpy:

    Yes, that eyelid plastic surgery is covered by Medicare if medically necessary.

    Had a relative who got it and could see great when done.

    I thought it was hysterical...we teased him about getting it just to look younger.

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  23. arzt4empfaengerAugust 9, 2011 at 3:11 AM

    Packer - thank you for the laugh! Tarantulas on the face is the best description I've seen for those humongous lashes. :D

    Journals. They publish the most amazing things (and not all are positively amazing).

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  24. JessieAugust 9, 2011 at 8:29 AM

    Yes my Aunt's surgery was covered by medicare. Her surgeon did a good job. She didn't look "done", just well rested (she was in her 80's) and more importantly now she could see. I expect my older brother will need the same surgery someday, he has that side of the family's facial structure and at 50 his eyelids are already droopy.

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So wadda you think?