The Solar Eclipse: Even Better than Expected!

Rarely does an event with as much hype as the 2017 Solar Eclipse live up to expectations. Preparing for this week's eclipse, I was moderately excited and figured it would be a neat thing to see, but I anticipated feeling a little let down when I actually saw it. I was wrong!

Leading up to the eclipse, I was honored to be interviewed on the local CBS Evening News, discussing why and how to view it safely. Here's a link if you'd like to see the video.

On the day of the eclipse, I was in the operating room, doing surgery for patients with strabismus to help realign their eyes. In between surgeries, I had a minute to peek out the window and see the eclipse as it was developing. Here in Spokane, we weren't in the path of totality, and because of the surgery schedule, I didn't get to see the partial eclipse at its maximum, but I was caught off guard by how cool it was. Seeing a crescent sun in a black sky with my eclipse glasses was definitely neat.

I was also pleasantly surprised to see the social media reaction -- it seems I wasn't the only one who found the eclipse incredibly cool. Videos from all over the country, especially those from people in the path of totality, showcased what an incredible experience this was.

If you looked at the eclipse in an unsafe way, and are now experiencing decreased vision or a blind or dark spot in your central vision in one or both eyes, you may have a condition called solar retinopathy. Solar retinopathy is a burn, caused by ultraviolet light, of the retina, the inner lining of the back of your eyes, and the home of the rod and cone cells that sense light. There is no treatment for solar retinopathy, and although some patients' symptoms may improve over the ensuing months, other people's vision loss may be permanent. If you think you may have this problem, you should see your eye doctor.

Today, the local CBS Evening News invited me back for another interview, to discuss solar retinopathy symptoms and what to do if you think the eclipse may have damaged your eyes. Here's the video of the interview.

Finally, here is a video generously shared with me by my friend Melanie Slater Munns, which shows the magical moment when the lights go out during the eclipse in the path of totality:

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Through Their Eyes

Different vision problems can affect our eyesight in different ways; not all eye problems cause blurriness or can be fixed with glasses. Here are some images I created that help illustrate how the world looks with different types of eye conditions. These images are based on the pathology that is causing the issue and on my experiences talking with patients.

Will wearing glasses fix it?

Wearing glasses helps fix some eye problems, but certainly not all of them.

There is a common misconception that any eye problem can be fixed by wearing the proper glasses. This, unfortunately, is not true. Glasses and contact lenses help correct eye problems related to focus, and that's it.

Think of the eye as a camera. If the camera is out of focus, then it won't take a good picture. Focus the camera (or wear glasses, in our analogy), and you'll have a clear image.

Extending the analogy, here are a few categories of eye problems that cannot be fixed by wearing glasses:

Cataract (lens smudged)
Corneal disease (cloudy screen)
Optic nerve disease (dead battery)
Retinal disease (bad film)

What is this thing?

A phoropter is used to measure refractive error.

The device you see pictured here -- from the cover of Justin Timberlake's 2013 album "The 20/20 Experience" -- is called a phoropter.

Used primarily to help determine a patient's glasses/contact lens prescription, it has been around for over 100 years. It contains dozens of different lenses which can correct for hyperopia, myopia, or astigmatism. With you seated comfortably, with both eyes open, and your forehead up against the back of the phoropter, the eye doctor will show you an eye chart and check each eye individually with different combinations of lenses. He or she will ask you which is sharper: #1, #2, or if they are the same. The goal is to find two options that appear the same to you in terms of clarity/sharpness. Based on the results, a prescription for eyeglasses or contact lenses can be issued.

What is astigmatism?

Astigmatism occurs when the focusing structures of the eye -- the cornea and lens -- are not perfectly round.

I get this question a lot, and since it's often misunderstood, I thought it would be a great topic to discuss.

Astigmatism, along with the previously-discussed entities of hyperopia (farsightedness) and myopia (nearsightedness), is one of three common types of refractive error. Refractive errors are problems with the focusing system of the eyes.

A normal eye is round, like the baseball you see here. An eye with astigmatism, by contrast, has a cornea -- the clear, front part of the eye that focuses light -- that is steeper/more curved in one axis and flatter in the axis 90 degrees away, like a football. This means that light in an eye with astigmatism is focused at two different points on the retina, creating a blurry image.

Astigmatism, like all refractive errors, can be corrected with glasses, contact lenses, or laser surgery (e.g. LASIK). It is easy to identify in a routine eye examination.

What does it mean to be "farsighted?"

The anatomy of hyperopia, or farsightedness

In the simplest of terms, people who are farsighted have an easier time seeing far away than up close.

Why is this? Well, a farsighted eye is an eye that is either too short or too weak. Take a look at this picture. The image is focused behind the retina, not right on the retina where it will be sharpest. You can imagine that this could happen either because the eye is too small, or the focusing power is too weak.

Now, here is where hyperopia is a bit different from simply the opposite of myopia. Young people have the ability to accommodate -- to increase the power of their lens focus -- and this can neutralize farsightedness. Hence, a young person who is farsighted may have no trouble at all seeing far away or up close, even if their prescription is high, because there lens can change shape and focus the image. The natural decline of this ability with age is called presbyopia, and is the reason why many people need reading glasses beginning in their 40s and 50s.

If a person's hyperopia is significant enough to warrant correction, the available options are the same as those we discussed last time, for myopia, namely: glasses, contact lenses, and corrective surgery.

Why do stars disappear when I look directly at them?

Stars disappear when you look directly at them because of the anatomy of the photoreceptors in your retina.

We all have two types of light-sensing cells in our eyes, the rods and the cones. Cones see fine detail and color. Rods see better in dim light. When you look right at something that is small or far away, the image falls on a part of your retina where there are only cones. This means that if you're in a well-lit environment, you will see this object very well. If however you are in dim light, you'll see the object better out of your peripheral vision (looking just off to the side of your target) because then the image will fall on the part of your retina that has rods, which can see in dim light. This is true of everyone's eyes, but many people have never noticed it. There are a few VERY rare conditions that can exaggerate this phenomenon, but they are like 1 in 10,000 level rare. A dilated eye exam could detect them.