It’s Election Day, so let’s talk about why our eyes get puffy when we cry
We have 3 kinds of tears: basal tears (always there), reflex tears (noxious stimuli), emotional tears (democracy collapsing).

Emotional tears come from the lacrimal gland, the big ass gland in your upper eyelid, pictured here by Netter
When you cry heavily, like when somebody breaks up with you or you’re on a step 1 test break in the prometric bathroom, the lacrimal gland goes into hyperdrive. All that activity eventually causes inflammation and swelling around the gland
Additionally, emotional tears have a slightly lower concentration than other types of tears as well as the periocular tissue. Therefore, all that excess cry water will move to the surrounding higher concentration tissue, causing swelling
Then you enter into a vicious cycle where you get all swollen, then you look in the mirror, which makes you cry even more and you get even more swollen. The cycle continues until your brain says “ok good lord that’s enough” and makes you fall asleep.

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More from @DGlaucomflecken

12 Sep
Roughly 100% of people on the west coast are dealing with burning eyes from wildfire smoke, so here are a few eye care tips...
First, invest in some artificial tears. No redness relievers. If you use visine, you might as well just waft smoke directly into your face while screaming “why is this not helping?!”
Don’t rub your eyes or at least wash your hands before rubbing your eyes. You don’t want dirt, ash, or gender reveal party residue to be transferred from your hand to your eye.
Read 5 tweets
4 Sep
Let’s talk about floppy iris syndrome. That’s right, in a specialty with complicated words like “phthisis” and “glaucomflecken,” we have a thing called floppy iris syndrome.

It’s time for the ophthalmology/urology crossover you never thought you needed and probably still don’t.
Alpha 1 blockers like tamsulosin relax smooth muscle in the urinary system. Unfortunately, they also relax the iris dilator muscle, despite repeated requests by ophthalmologists that they please not do that
As a result, the pupil fails to dilate and becomes a giant pain in the ass during cataract surgery. In this video, you can see the iris constantly moving in and out. This slightly increases the risk for complications like iris injury, hyphema, and posterior capsule rupture.
Read 8 tweets
20 Aug
Call night 1/7: 2 pages

5:30pm - Rx clarification from pharmacy

5am - ED, patient punched in the face, swollen eyelids but no orbital fracture, vision 20/30, follow up in clinic this morning

Difficulty rating (from 1-5 eyeballs): 👁
Call night 2/7: 2 pages

5:48pm - Patient with a scratchy eye 1 day after eye surgery. Reassurance provided.

8:30pm - Thought I heard a page, but it was just the clothes dryer beeping

Difficulty rating: 👁
Call night 3/7: 2 pages

8:37pm - Patient call, flashes/floaters, met him in clinic for exam. No problems.

2:45am - ED, flashes/floaters, decreased vision, follow up in clinic this morning

Now on my way to clinic this morning with box of kolaches for the staff

Difficulty: 👁👁
Read 4 tweets
31 Jul
Today, I met the people who saved my life.

I’ve been tweeting about my cardiac arrest since I woke up in the ICU and re-downloaded twitter (@LGlaucomflecken deleted it for my own safety and concluded that if I could figure out how to get it back, I was safe to tweet again)
Now almost 3 months, hundreds of tweets and 1 electric bra later, I was finally able to meet the EMTs, firefighters, and call operators who responded that night and hear about their experience
I heard about how they had responded earlier that night to a house fire only to get called again a few hours later when my heart stopped beating.
Read 10 tweets
20 Jul
I get asked about blue light blocking glasses more than anything else. It’s a topic I am deeply uninterested in, so here’s a thread about blue blocking (BB) glasses so that maybe I will never be asked about them again.
Advertisements for BB glasses focus on 3 selling pts:

#1 improve sleep: This is the only potential benefit. Blue light can screw up melatonin levels, so buying these to help you sleep is defensible, OR just don’t stare at your phone before bed. Lmao I’m kidding that’s impossible
#2 reduce eye strain: Ah yes, it’s blue light, a color found everywhere that’s causing strain, not the fact that we hold our devices 10 in from our faces for days nonstop. Take breaks. Blink a little. This will help with headaches/fatigue from eye strain way more than BB glasses.
Read 5 tweets
5 Jul
Alright I’m gonna try to explain astigmatism, because this is an extreme example of what you might see at night if you have it.
Astigmatism is all about the cornea. You can have astigmatism in the lens as well, but I want you to read this thread so let’s keep it simple
Somebody with NO astigmatism has a perfectly spherical shape to the cornea, like if you cut a basketball in half and sutured it to the front of the eye (unethical). Every ray of light entering the cornea would be PERFECTLY focused onto the retina allowing 20/20 vision.
Read 7 tweets

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