Blog vol 4.4. Water, water, everywhere.
And so it seemed. Yesterday, my opening staff was greeted with water all over the floor by the patients’ bathroom. Initially, they looked up at the ceiling; with the recent cloud bursts, did it come through the roof? No (awesome:). The bathroom door was opened to discover that the toilet was overflowing. Fortunately, it was clean water, not sewage, that we were dealing with (again, awesome:). So what happened?
We have had problems with the float in the tank. It must have got stuck and kept the water flowing, which the toilet would usually handle because there is an overflow on the bowl, unless….. the line is blocked further up. We finally discovered that the pump or line further down the pipe was either blocked or not working causing the overflow at the toilet. Stay tuned as we continue the “Saga of the Backed-Up Bowl”.
Why all the hubbub on such a humdrum topic?
The flow of water and its drainage are a great analogy for the condition we call glaucoma. This month is cataract awareness month, but every month is glaucoma awareness month. Glaucoma is sneaky and insidious, just like that slow leak in the toilet bowl and if you are not careful, you can easily have a mess on your hands.
First, a little review of anatomy and physiology. Near the front of the eye, just behind the iris, is a structure called the ciliary body. It produces a clear fluid, called aqueous humour, which is the eye’s way of circulating nutrients and oxygen to all the clear structures of the eye like the cornea and the lens. The circulation of the aqueous also removes waste and debris and maintains the eye’s shape and pressure.
Glaucoma happens when the optic nerve and the neurons in the retina are damaged by high pressure in the eye. The ciliary body is like the tank filling up in the toilet and there is a switch in the eye that stops the water from flowing to achieve a healthy balance. As with the toilet, if the water has no place to go then it overflows or in the case of the eye, the pressure builds.
Catching this process is the problem, much harder than detecting water on the bathroom floor. A regular visit to your optometrist is critical. We now have really neat tools like Optical Coherence Tomography (OCT) and pachymetry that help us detect glaucoma earlier. We have treatments that can reduce the flow or production of aqueous and other treatments that increase the outflow (sort of like pulling the plug on the blockage). The main thing is that you have to catch it, get the pressure down, then do regular maintenance.
By the way, there is a happy ending to the “Saga” as the plumber found a faulty backflow flap. Replace that and get the flusher fixed and we will be right as rain. We have nice clean floors and a great analogy for this blog: the right amount of fluid in the right place is great; too much is bad…
Getting your eyes checked regularly is the surprise moral of the story.
‘til next week,
the good doctor
