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When a Laser Pointer Meets an Airliner: New Glasses Built to Protect Pilots' Eyes By Paddy Kalish, OD I spend my days in an exam room in Brookline, looking into people's eyes. I spend a fair amount of my other time writing about aviation — I am the author of Flight of Fate — and thinking about what can go wrong, and right, at 35,000 feet, and more importantly, in the few hundred feet just above a runway. So when eye care and aviation safety meet in the same story, I pay attention. This one deserves your attention, too, even if you never sit in a cockpit. Because the hazard is a gadget many people have in a desk drawer, and the people at risk are the two pilots guiding your next flight down through the dark. A small pointer, a very big problem A pocket laser pointer feels harmless. It makes a bright dot on a wall, your cat chases it, and that seems to be the end of the story. Pointed up at an aircraft, it is a different story altogether. A laser beam spreads as it travel...

Every so often, a patient sits in my chair and tells me a story that stops the small talk cold. "Doctor, last Tuesday my right eye went dark — like a shade being pulled down. It lasted maybe two minutes, and then it just… came back." No pain. No injury. Nothing to see by the time they reach me, because the eye looks perfectly normal again. That little episode has a name — transient monocular vision loss — and when we suspect a tiny embolus caused it, we call it amaurosis fugax, Latin for "fleeting darkness." It is one of the most important stories a patient can tell me, because it is a symptom, not a diagnosis — and sometimes it is the only warning before a stroke. A blackout in one eye is a TIA of the eye Here is the idea I need every patient to carry home: if a blood clot briefly blocks the circulation to one retina, that is a transient ischemic attack — a TIA — that happens to announce itself through the eye instead of through speech or a weak arm. The American H...

Contact Lens Insertion and Removal — Paddy Kalish, OD By Paddy Kalish, OD Learn how to insert and remove soft contact lenses safely with Paddy Kalish, OD — including when to wear your lenses, where to handle them, proper hand hygiene, and the warning signs that mean you should leave your lenses out. More eye care guides at paddykalish.com. Video: Contact Lens Insertion and Removal — Paddy Kalish, OD Originally published at paddykalish.com .  

Tethered Cord Syndrome: When the Spinal Cord Is on a Leash By Paddy Kalish, OD — optometric physician, Brookline, Massachusetts This is the condition behind a case I wrote about recently — the one neurosurgeon Dr. Betsy Grunch shared, where ChatGPT spotted the pattern after many doctors had missed it: tethered cord syndrome, or TCS. It's worth a fuller explanation, because TCS is a master of disguise. Its symptoms creep in insidiously, and unless a clinician keeps tethering on the list of possibilities, they get filed away as muscle strain, aging, or "functional" complaints — while the real problem quietly progresses. What TCS is — and what it isn't "Tethered cord" describes abnormal fixation of the spinal cord that limits its normal movement inside the spinal canal. Your cord is meant to glide a little as you bend and move. When it's anchored down, traction does two kinds of damage: it impairs the cord's blood flow and metabolism, and it mec...

Atropine: The Eye Drop That's Also an Antidote By Paddy Kalish, OD Here is a piece of medical trivia I never get tired of. Centuries ago, Italian women put drops from the deadly nightshade plant into their eyes to make their pupils large and dark — considered the height of beauty. The plant's Italian name, bella donna , means "beautiful lady." The active ingredient in that dangerous beauty trick is the very same medicine I keep in my exam room today: atropine . Atropine is one of the hardest-working medicines I know. It rides in ambulances, stands by in emergency rooms as an antidote to poison, and sits quietly in eye clinics like mine. What fascinates me is that all of those jobs flow from a single, simple trick — and once you understand the trick, the whole résumé makes sense. One trick, explained plainly Your body has two broad "modes" of automatic control. One speeds you up for action. The other — the rest-and-digest mode — slows the heart, gets...

By Paddy Kalish, OD Almost every week, a patient with macular degeneration asks me the same question, usually with a little fear behind it: "Doctor, my mother lost her vision to this. Is there anything I can take so it doesn't happen to me?" For a long time, my honest answer had a gap in it. We have a proven vitamin formula for intermediate AMD — the AREDS and AREDS2 formulas, which cut the risk of progressing to advanced disease by about 25% in the original AREDS trial. But for early AMD, the stage far more of my patients are actually in, there has been no treatment with real evidence behind it. Nothing. Watch and wait. That's why a recent conversation caught my attention. On Ready, Set, Retina , Dr. Daniel Epshtein and retina specialist Dr. Priya Vakharia walked through the emerging evidence for something humble: B vitamins. Here's the story as I'd tell it to you in my exam chair. The heart trial that wasn't supposed to be about eyes The strongest...