Transcript

[00:00:00] Today’s episode is brought to you by Dax CoPilot from Microsoft. Dax CoPilot is your AI assistant for automating clinical documentation and just being more efficient, reducing administrative burden, all that stuff that makes us feel overwhelmed and burnt out. To learn more about how Dax CoPilot can help you help improve healthcare experiences for both you and your patients, stick around after the episode or visit aka.

daxcopilot. com. Dot ms slash knock knock. Hi, that’s a k a dot ms slash knock knock. Hi.

Knock knock. Hi.

Hello everybody. Welcome to knock knock. I with me, Dr. Glaucon Flecken. This is your one stop shop for all things eyeballs and occasionally some like non eyeball related stuff. I always bring it [00:01:00] around eyeballs though. You know, I have to, uh, Ophthalmology, all right, you do know how to spell, you know, you can’t listen to this without knowing how to spell ophthalmology, by the way.

Like you get one free pass, one free episode, you can get through it, you can listen if you don’t know how to spell it, but then you got to go and do some homework. I need you all to know how to spell ophthalmology. It’s very important to me. O P H T H A L M O L O G Y. It’s easy, folks. Come on. Anyway, I’m just kidding.

You don’t have to know how to spell ophthalmology. It’s nice, though. Makes me feel good when people know how to spell my specialty. Anyway, I hope you’re all having a good day. Um, as always, I’m recording this late at night. I just put my kids to bed. It’s hard to get my, my, uh, my kids to bed these days. My oldest is, uh, into drumming now.

She’s very musical, very artistic. She’s a fantastic artist. Don’t know, have no idea where she got that [00:02:00] from because I am not. Uh, Kristen is not. She’s very good artist, and she’s also into music, and so she plays different instruments, but she recently got into drumming, and, uh, she’s, she’s taken lessons, and, uh, she’s been begging us for a drum kit.

Now, like, I can tolerate a lot of noise, um, I think Kristen can tolerate less noise than me, and so your classic drum kit was not really an option. So we got one of these electronic drum kits that you put headphones on, and it just makes much less noise than an actual drum kit, and she’s loving it, spending all this time on it.

So. I don’t know. I don’t know how to help it. Anybody have suggestions on how to like, like, what do you buy? Like music? Like you would, like when I, when I was learning how to play trombone, shout out trombone players. I was a trombone. I look like a trombone player. [00:03:00] I got the long arms and I’m just like a classic trombone person.

And that doesn’t even mean, doesn’t mean anything. I don’t know. Uh, but, uh, uh, you know, you could buy like music books. Do they have that for drums? I know nothing about the drums. So anyway, I’ll keep you guys updated on the drumming that’s going on in her house. I have, I don’t really know how to help her, but fortunately she’s like really good at helping herself and just figures this stuff out.

But, uh, if you have any tips for me as a drum dad, I’d love to know. Okay. So, uh, it’s been an exciting beginning to our live show tour. We just got back from Washington, DC, uh, just a few days ago and a shout out all you people in Washington, DC area who came out to the show. Um, and it was just, we were at the Howard theater, uh, the packed house, just a great reception, lots of laughs, Some [00:04:00] tears as usual with our show.

Uh, and, uh, uh, but what are the reason I want to talk about this and I promise you, this is going to come around to eyeballs in a second is, um, I, I, I just love Washington, DC. I love visiting. I’ve been a number of times and there’s, there is so much to do. I made a joke on Twitter about, uh, I mentioned that I was going to Washington DC for the show and that, um, It’s uh, uh, uh, you know, I know that they have the Exorcist stairs, the famous stairs from the movie The Exorcist, but like there’s really nothing else to do there.

Anybody have any suggestions? That was the joke. Because there’s so much to do in Washington DC, it’s overwhelming how many things there are to do. Uh, and so, um, but this was special because this was, uh, Kristen and I, this is our first time without kids. So, you know, we, we’ve, we’ve done things like we’d seen, you know, a few of the different museums that we’ve, we’ve been separately, [00:05:00] uh, the two of us, we’ve never been together.

So you’re like, Ooh, let’s do something that, that, you know, If we had kids with us, there’s no way we’d be able to do. And so obviously we’re like art museums. There’s no way like the air and space museum. The kids would like that. The spy museum. That’s a new one I hadn’t even heard of, but everybody told me about that.

Uh, that’s one that the kids would like. And so, uh, our kids don’t have, obviously my oldest who I’d mentioned is artistic. Like she, she would probably enjoy the art museums, but my youngest, no way. She’d last. 30 seconds, and they’d just be complaining. So we’re like, let’s do some art museums. So we went to, uh, the, um, uh, the Smithsonian, the, the, the, the, what’s it called?

The, the, the art museum, the American museum of art. That’s what it is. American museum of art. Um, uh, we went there and we saw the, the, the hall of [00:06:00] portraits. We went there. That was really cool. That’s probably my favorite part of our art extravaganza. Uh, what was the other one we went to? There’s, there’s the other big art.

That’s not the Smithsonian one. Uh, it’s on the mall there. Okay. The name is escaping me, even though I was just there three days ago. I’m tired. You guys, it’s been a long day. Don’t get mad at me. Um, God, that’s the name is going to come to me of that place we went to, but that was, that was also, uh, uh, Dang, I’m, I’m really, I’m, I’m losing my mind here.

Okay. I’m going to, I’m going to Google it right now. Uh, let’s see, Washington DC art museum. This is what you come to a, to a podcast for, uh, right here. National gallery of art. God, how did I not remember that? Anyway. So we went to the National Gallery of Art, saw like your classic impressionist and, and famous, like we saw some, we saw, uh, we saw a da Vinci, that was my first time ever seeing a da [00:07:00] Vinci.

Uh, we saw some Rembrandts and various other artists. But what I really want to talk about is the, the, the portrait gallery. The portrait gallery was, was so cool. Uh, especially the hall of presidents. This is where they have all like the, the presidential portraits in here. I mean, all the presidents had multiple portraits, but they put all the presidents in this room.

And I, I’m just kind of like a presidential history guy. I can remember back in like fourth grade, I was like reading presidential biographies because I was just a really cool kid. Yeah, I just, I, I will like reading like a, uh, a biography of like Warren G. Harding. It’s, I don’t know. It’s, it’s just, uh, it was, I went through a phase, I had a phase growing up.

I was just like into presidents and learning about the presidents. And so, uh, and so [00:08:00] part of me still has that kind of like interest in, in that his, that part of history. And so I was like super excited. I’m going to go see all the presidential portraits. And what was the first thing I did when I went there?

I tried to figure out, I went around to see how many of the presidents in their portraits were wearing glasses. Obviously, like that was what I wanted to know. Uh, and so, uh, I went around, and do you know, I have a list, I have a list of all the presidents who are depicted wearing glasses, or having glasses with them.

I had to expand the criteria a little bit. Alright, so, uh, uh, do you know how many? Can you guess? Think about it right now. Think about your guess. All right, here we go. Five. There are five presidents that have some proximity to glasses. Okay, here we go. We don’t see, the glasses don’t make an appearance until Woodrow Wilson.

The 28th president of [00:09:00] the United States of America, good old Woodrow Wilson, uh, the guy who, uh, was basically led us into World War I and, um, uh, he was president from like, uh, was it 1913 to 19, 21. That’s a long time. And 8 years. Two terms. Well done, Woodrow Wilson. Alright, so, some of his portraits didn’t portray him wearing glasses.

Some of them did. As if you guys care, but you know what? We’re gonna do this. So, because I had a good time figuring this out. Alright, next one. Alright? You know what? Woodrow Wilson, 28th? Well, guess what? The 29th president, Warren G. Harding, also saw He was like, oh, this guy looks great in glasses. I’m gonna wear my glasses.

That’s right. Warren G. Harding, president number two. Glasses wear. And the presidential portraits. [00:10:00] Uh, let’s see Warren G. I don’t really have a lot of information about Warren G. Harding, uh, other than the fact that he was president, uh, um, during the famed Teapot Dome scandal, which was a bribery scandal involving the administration of Warren G.

Harding. And at one point was known as the greatest and most sensational scandal in the history of American politics because there was a senator or somebody in the cabinet. In Warren G. Harding’s cabinet, who accepted bribes from oil companies. And, uh, it was the only time that someone in the administration went to prison.

It was a big deal. So, there you go. Warren G. Harding. And then we have to wait until the 32nd president. Oh no, I missed one. Obviously, Theodore Roosevelt. Theodore Roosevelt, the 25th president. All right, that’s the first time. I’m so sorry, Teddy. How could I forget Teddy? [00:11:00] Because, uh, he’s the only, uh, the only glasses, it’s the only time that glasses, as far as I know, have been cut into a mountain.

Mount Rushmore. Teddy Roosevelt. Love it. That’s the only reason I’m, I don’t know much about Teddy Roosevelt. Um, turn of the century, 19th, uh, 1900s, uh, president. And, uh, he wears glasses and the, he loved his glasses so much that he wanted them cut into the mountain for Mount Rushmore, although I don’t know when that was done, so maybe he was, he was long gone by then.

Uh, I would say, so Roosevelt, uh, then Woodrow Wilson, Warren G. Harding, then we got Harry S. Truman. Here is Truman, World War II, dropped the bombs, and then we have the last one, Dwight D. Eisenhower. There are, they’re all like right there, 25 to 33, that was like, like the golden [00:12:00] age of presidential glasses wearing.

Dwight D. Eisenhower, last one. Now he is not really wearing them, they’re like, In the portrait, they’re like on the, on a book or something. So that’s like partial credit. Uh, but, uh, I still count it because it’s like a good depiction of glass. The glasses look great. He’s fine too, but the glasses in the portrait look great.

So there you have it. Five presidents and some proximity to glasses and their presidential portraits. I appreciate all of them. Thank you for that. And let’s take a break.

Alright, for those of you who are still listening after I went through how many presidents were wearing glasses in their presidential portraits. Jesus Christ, I can’t believe I have sponsors for this. Thank you, people that support me. Uh, Jesus, okay. Well, anyway, I had a wonderful time in Washington, D. C.

Great show. [00:13:00] We got another one coming up. West Nyack, New York, a place I’ve never been to. Apparently the, uh, the improv theater that we’re performing at is in a mall. A little blast from the past. The Palisades Mall. It’s like a famous mall. Still going. I’m excited to walk the mall. I would, so what I want to do, I want to walk around.

I want to see what, what, uh, what malls look like in 2024. For as Ben. a minute since I’ve been inside a mall. All right, I’ve got another topic before we get to eyeballs specifically. All right, big news. In healthcare, big news in, in residency training programs. Uh, the AAMC, the American Academy of Medical Colleges.

I think that is the AAMC is having a rough time. They’re having a rough time. So the AAMC. People don’t, they’re, they’re not great. All right. People have [00:14:00] problems with the AAMC. They’re the ones that run ERAS. So this is the Electronic Residency Application Service. So for years and years, almost every.

Every specialty in medicine outside of a couple, namely ophthalmology, we have our own little application match system. I think urology also does their own thing. Um, could be wrong about that one, but anyway, all the specialties for a long, long time, um, save for a couple used. The AAMC’s ERAS service. And so basically what you do as you’re, if you’re a med student applying to residency, you, you type, you put in your application, it’s a whole thing.

You got to do all your, your CV and your, your scores and your, you have to upload your letters and, uh, you put your talk about your hobbies. Hiking. That’s actually automatically populated. Yeah. [00:15:00] Your love of outdoors is already put in there. We know that you love the outdoors. Uh, research experiences, all those things.

It goes into this ERAS. electronic application, and then it gets sent out to all the programs that you wanted to send it to. And it’s a tiered payment, uh, a fee structure. So like your, your first 10 Programs you want to apply to are like X amount there. I don’t know. I don’t know the updated what it’s been.

I don’t even remember what it was when I applied. Um, but it’s like a certain amount of money for the first 10 and then the next 10 programs, if you apply like 20 programs, well, the next 10 of them are more money. And then if you apply to 10 more above that, it’s more money. Like, the fee per program gets higher the more programs.

It’s [00:16:00] like punishing you for wanting to, to, to, uh, to apply to more programs. And now, and this is obviously, this adds up. Now we’re talking like thousands of dollars that med students. Are forking over thousands of dollars they don’t have to apply to residency. And so for years and years, there’s like, we’ve, you know, med students, everybody, residents, just people in medicine have been bemoaning the, the, the high cost of, of applying to residency, which is something you have to do.

And so people are taking out loans. I took out a loan to apply for residence. It just, it sucks. And. The AAMC, as a result, the people that run this program, of course, like, people just don’t like them. And the biggest problem is because, the biggest reason is because the ERAS system, that is like their cash [00:17:00] cow.

They make millions. And millions of dollars off of this application service. And it, sometimes it doesn’t like work well and it’s, it’s like predatory in terms of the, just the sheer amount of money that, that they’re getting from this, from doing this, uh, and then for like. You know, you know, how much, how much does it cost to run it?

Like this is all this concern about like, you know, this is like kind of a predatory practice. Well, anyway, recent news is that some residencies or some specialties are starting to get fed up with it and they’re leaving. ERAS. That’s right. They’re leaving the Electronic Residency Application Service. They are pulling out away from the cash cow of the AAMC and the AAMC can’t be too happy about this.

So recently, now it’s emergency medicines turn. So [00:18:00] the OBGYN residencies, they have pulled out and they started their own service. This is like residency CAS thing. It’s apparently gone pretty well, like fairly smoothly. They just do their own thing, because why not? Like, you don’t have to do the same thing that, like, OBGYN doesn’t have to do the same thing internal medicine does, and pediatric does, because they’re their own programs, they’re their own specialty.

They can do whatever, they can build their own, which is basically what OBGYN did. They just develop their own, application system. Cause why not? And so emergency medicine was like, Oh, I like this. This seems better. This seems more functional. This seems like we just do our own thing. And so they’re actually maybe going to what, uh, to use the same thing that OBGYN is doing, but most importantly, they’re leaving.

The AAMC. You know what? I’m all for it. Hey, let’s, let’s, let’s distribute the power a little bit more. Let’s not like [00:19:00] give this one organization all this money, uh, that, that they use to pay all their executives a ton, uh, all on the backs of, of, of med student loans. That’s what’s funding this organization.

Med school loans. Money that med students don’t have that they have to pay back. It’s all, it’s a lot of it’s going to the AAMC. So, yeah, I’m all for it. I love it. I love it. Absolutely. You know, you know how I do. You know guys, I love when, when you take like something that’s basically been monopolized in healthcare and you work to destroy it.

Big fan, big fan. Don’t like the monopolies in healthcare. And there’s a lot of them from PBMs to, to, to insurance companies, which are basically the same thing now to the AAMC to Elsevier to [00:20:00] Springer academic publishers. Don’t like the way they do business. Let’s tear them down. Uh, okay. So that’s the recent news and healthcare.

Let’s see how we’re doing on time here. So yeah, let’s keep going. All right. I got plenty of time. Uh, to talk about our eyeball topic. So I went through the YouTube comments of our, the most recent knock knock eye episode that was posted. Uh, it was, uh, I talked about worst case eye problems, the eye problems that would not want to have, uh, including acanthamoeba keratitis, a devastating, potentially devastating, horrifying eye infection of the cornea.

An infection of the cornea I would never want to have. It’s like my least, if I have a favorite, it’s my least favorite, uh, eye infection. I would not want to have it. I don’t want to treat it. I hate having to treat it. I hate it when people get it because it, it’s, it’s a blinding condition and it’s, [00:21:00] most importantly, Avoidable.

So anyway, I did an episode about a can muic keratitis and, uh, uh, I just, uh, was, I was going through the comments. Thank you all. Please comment at Glock and Flecking, sorry. All of these YouTube or, uh, knock, knock eye episodes are up on YouTube. And, uh, say I had some great comments, but I wanna talk about one in particular that’s gonna set up, uh, our topic.

And that was, oh, um. At Morningstar 4040, uh, who was, uh, at first it was talking about the, the episode where I did state driving standards, which was very interesting for me and for the audience. You guys love hearing about that, but also said, uh, this person also said, our infant’s congenital glaucoma was misdiagnosed as a blocked tear duct for 11 months, leading to permanent congenital glaucoma.

Compromised vision and one eye. While congenital glaucoma is rather rare, can you briefly [00:22:00] discuss the warning signs for physicians and caregivers who listen to your channel? I love that suggestion. That is such a great idea. Uh, so real quick, just to address this particular Um, a concern, congenital glaucoma is, um, is something, it is rare and it can be misdiagnosed because we are, it’s drilled into our heads from the beginning of residency that there are a couple of very, uh, important, very significant signs that a newborn.

Might have congenital glaucoma. We’re talking like zero to three months old. And those things are tearing, tearing and blepharospasm, light photosensitivity. Basically like the infant doesn’t seem to want to be around light. Bright lights really bother. That is because often there’s a little [00:23:00] bit of cloudiness to the cornea whenever you have congenital glaucoma because you have a high eye pressure and a, and a little baby.

And that can cause, uh, that can push fluid into the cornea and cause the cornea to be cloudy. And if you shine light on a cloudy cornea, it basically defract the light and just it, it kind of glares out the vision and can be really uncomfortable for people. That’s why people who have cataracts, hey, driving at night.

Because the bright lights from the headlights, it hits the cataract, it scatters, and it just causes all this glare. Well, kind of a similar thing with congenital glaucoma. An old baby has a cloudy cornea from high, high, high eye pressure is not going to like bright lights because of the cloudiness in there.

And then the tearing is actually typically a sign that just the, the eye The system itself, the way everything works, including the [00:24:00] tear drainage system, is immature. And so, little babies who have tearing, it could be a blocked tear drainage system, that could be it, but it could just be a very immature system.

And if the tear drainage system is immature, then the aqueous drainage system inside the eye may also be immature. Because normally, we’re born, we have a functioning trabecular meshwork that drains, allows the fluid that our eye makes, the aqueous fluid, it makes it, the eye also drains it. And when you’re born normal, in a normal eye, that drainage system is intact.

But in an immature eye that just didn’t develop normally, you can have certain things like the tear drainage system and the trabecular meshwork that just hasn’t developed [00:25:00] correctly. And that can lead to tearing, but it can also be a sign of something more serious, like a blinding condition, like congenital glaucoma.

So that’s what I, that is, if you take away one thing from this episode, especially if you’re a physician. Who sees kids, who sees babies, neonatologist, pediatrician, family medicine, uh, general practitioner, whatever, whoever, whatever you are. Um, a little infant with tearing. They gotta have an eye exam. They gotta have an eye exam.

Okay. Very important. Uh, okay. But that leads to a great topic that we’re gonna do for the rest of this episode, which is Just very simply, child eye problems you shouldn’t ignore. Alright, let’s take a break. I’ll be right back.

[00:26:00] Okay, here we go. So, this is, uh, again, basically symptoms, things that you see. Not just symptoms, but also signs. Symptoms and signs of that little kids might have. That you as a parent or you as a, a healthcare provider, physician, nurse, whatever it is you do, if you take care of kids, you don’t want to ignore these things that might come into your clinic or your urgent care or your emergency medicine or emergency department.

Um, uh, these are things that you, uh, you want to pay attention to. Okay. So child, I problems that you should never ignore. So we’re going to start with. Blinking, aggressive blinking, or rubbing of the eyes. So the most often reason why like kids will just will frequently rub their eyes is allergies. Very common.

You know, a sign of [00:27:00] allergies would be the eyes look a little red, there’s a little redness around the eye, they’re having sneezing. Runny nose, other signs of allergy, they get, they have eczema, there’s other signs that this is a child that just tends to have allergies. Alright, so that’s the easiest explanation for why a kid might be rubbing their eyes.

Um, sometimes they can get a foreign body in their eye that causes them to rub a lot. But sometimes, Repeated blinking, like aggressive, you know, hard blinking. I don’t know the best, just forceful. So we’ll call it forceful blinking. Are you a hard blinker? Call your ophthalmologist. No, forceful blinking and rubbing of the eyes can indicate a refractive error.

So that can sometimes be a sign that a child is nearsighted. Maybe they’re very farsighted, but nearsighted, and they should have an eye exam because you can save a little kid’s vision, especially [00:28:00] under the age of 8 or 9, if you get them into glasses at an appropriate age. Alright, so, um, eye rubbing, repeated blinking, that could be nearsightedness.

Just a good idea, get an eye exam, alright? Pediatric ophthalmologist, or just a general ophthalmologist, or an optometrist, all those people can check a glasses prescription, alright? So just go in, get an appointment, see an eye doctor. Alright, so blinking or rubbing, that’s the first one. Um, another one. New spots on the eyes.

On the white part of the eye. That’s one. I just, I just had a patient not too long ago. Who, uh, it was a, it was a, a I want to say 10, 11, 12 year old, somewhere around there. Um, they noticed a, a new spot Uh, on the white part of the eye. Just a little nevus. Like a little brown spot. And that can [00:29:00] be Very rarely that there can be a problem with that, but they did the right thing.

They don’t know, so they came in to see me. I think it’s, it looks like a benign spot. Um, obviously any kind of pigmented spot on the white part of the eye, the first thing that we think about is could this be a malignant melanoma? type lesion. And so we look at things like, is there a lot of vascularity to it?

Is there, uh, is there a lot of different colors? Like, is it a homogeneous looking? Color change or is there like, you know, darker colors in the spot and lighter colors? Is the border of it irregular? Um, uh, what about the size of it? How quickly did it come on? All of these things we look at when we see when someone comes in to have a spot evaluated on the white part of the eye.

Especially Caucasian patients, they typically don’t have a lot of spots on their eyes. Um, there is, [00:30:00] uh, something called racial melanosis. And so black patients are more likely to have pigmented spots, not just black, but any of the darkly pigmented patients are more likely to have. Pigmented spots on the white part of the eye and that’s totally normal.

It’s only normal. That’s racial melanosis But for a white patient, it’s it’s less common and it’s it’s a little bit more worrisome Not to say it’s going to be a melanoma if you have a brown spot on it But it’s definitely something you need to get checked out. I have patients that come in and Once a year we check those spots on their white part of their eye and make sure it doesn’t look like melanoma or that it hasn’t changed in appearance.

We’ll take pictures and compare that year over year. So if you have a kid, you see a new spot, it could just be sometimes you get spots like that that come up, little brown spots that come up with puberty. Changes in hormones, alright? You can get new moles on your body [00:31:00] while you can get a little pigmented spots on the eye.

But just like you’d go see a dermatologist if you have a weird new mole, go see an ophthalmologist if you got a new weird thing on the eyeball. Alright, so that’s the second thing. Third thing. Difference in pupil size. This is very important. So if you just, now there’s this thing, so what we’re talking about is anisocoria.

Difference in pupil size. One pupil looks larger than the other and that can be in any lighting conditions, dim light, bright light, most people notice it in bright light because how often can you really see pupils very well in dim light. Um, but, uh, uh, That’s a pretty frequent consult that we’ll get as ophthalmologists is, Oh, someone told me that my pupils were different sizes, that I should get that checked out.

Yeah, it’s a good idea. The vast majority of the time, it’s what we call Physiologic [00:32:00] Anisocoria. So about 20 percent of the population has a small difference in pupil size between the two eyes. And it’s never more than about, maybe at most, 2 millimeters of difference. And we can measure it. Like we have little measuring things that we can hold up to the eyes, and I do that frequently.

Um. Um. Um. And so it’s, but it’s always something that you want to be concerned about, especially in kids, because there are, are certain, um, um, things, there’s congenital Horner syndrome, there’s obviously tumors, uh, uh, that can develop. These are all pretty rare things, but you don’t want to miss them, right?

Um, that, that can, uh, that can, Compromise the sympathetic nerves and give you one pupil that’s much smaller than the other pupil because there’s no sympathetic innervation. Just all parasympathetics, it’s going to cause you to have a small pupil. What we call meiosis as [00:33:00] opposed to medriasis, which is a larger pupil than average.

Uh, but if you’re, if you pay attention, if you’re examining a kid or, or you’re just a parent, you’re going to look at your kid’s eyes all the time, right? Uh, and you notice a clear difference in pupil size. You got to get them in to see somebody. All right. You can start with your pediatrician, but then often you’ll end up going to see an eye doctor, but sometimes you need that to get the referral to see someone like me.

All right. So a difference in people’s size. That’s big. Um, another one is what I kind of talked about already, which is, uh, like crusting, goopiness, uh, tearing, uh, which again, that in a, in an infant that could be congenital glaucoma. That’s like one neuron arc. We’re like, Oh, could this be congenital glaucoma?

Cause that’s the one thing you don’t want to miss, uh, in that age group. But, um, you know, it could be, uh, also a nasal lacrimal [00:34:00] duct obstruction. What we call it, NLDO. That could require surgery to fix. And just, if you, there’s, but it could also be just something as simple as, as allergies, or a pink eye, viral conjunctivitis, bacterial conjunctivitis.

But it’s always, you know, if you have any goop or crustiness or, or, uh, or, you know, uh, tearing of the eyes, uh, not a bad idea to at least, you know, get an appointment to see like urgent care or, uh, your pediatrician, give them a call, um, and then if it’s something that looks maybe a little bit more severe, maybe Like if it’s like in a two month old or a three month old, you know, chances are you’ll probably end up going to see a pediatric ophthalmologist because that’s a little bit unusual to have a lot of tearing in a little baby like that.

So anyway, keep that in mind most of the time with like a goopy eye, it’s just going to be a viral conjunctivitis [00:35:00] and that’s, that’s, you know, school age kids, uh, that’s most likely what it’s going to be. Right. And then sometimes you need antibiotics, sometimes you don’t. Um, but, uh, that’s something that’s, you know, I think it’s worth getting an appointment for, um, not necessarily an eye appointment and like an eye doctor, but, uh, in some cases that is a necessary escalation, but a goopy eye, honestly, like there’s a lot of different types of physicians, a lot of different types of healthcare professionals that can handle that kind of thing.

Misaligned eyes. Alright, so, if one eye is turned inward, outward, upward, downward, that is a sign of strabismus, which occurs in about 2 5 percent of children in America. And uh, this can be a big problem, it can lead to permanent vision loss in the form of amblyopia, which is where the brain just doesn’t learn [00:36:00] normal vision in that eye.

And so you want to try to avoid that. And so you want to take that seriously if you start seeing an eye that either all the time or it comes and goes, because you know, sometimes, you know, and usually we’re talking, it’s like within the first few months of life, like three to four months, it’s actually pretty common for one eye to like, Temporarily move in and out.

The eye, the visions, the vision system is trying to develop, but if it persists longer than a few months, or if it just becomes permanent, obviously if you have like one eye that is permanently stuck in toward the nose or out or up or down, like that is unusual. It should never be constant. The first few months of life, you can have like, mainly like the first two months, you can have the eyes can be a little googly.

If it’s, as long as it’s intermittent though, if it’s ever constant, you got to get that [00:37:00] checked out. Okay. So that’s very important. But then after a few months, like it settles in. So if you have like a, a two year old, you know, and one eye is constant, is like intermittently going in. then that kid might just need glasses, might need patching, might need but there’s only only one way to find out and that’s to go see an eye doctor.

All right, that’s that’s a very reasonable thing to get evaluated for. Um, and I guess the last one would be sometimes like head tilting. That’s the last thing I was able to come up with. Like head tilting or covering an eye because like clearly favoring one eye over the other. That could also indicate amblyopia.

So, you can have amblyopia without strabismus. Sometimes, kids will just, maybe they have one eye that has a lot of astigmatism to it, or they have one eye that’s nearsighted or really farsighted. [00:38:00] They’ll just, Ignore that I and sometimes to ignore it They’ll just cover it and they’ll just look at that with their good eye or there they’ll tilt because you know with the stigmatism They’ll the kids will often turn their face to seek to the side to see a little bit more clearly with astigmatism.

So it can be a sign of refractive error if you see head tilting, head turning, covering one eye. If you see that consistently, probably a good idea just to get a checkup. All right, get evaluated, get an eye exam for that kid. Again, ophthalmologists, optometrists, even school screening exams are decent, they’re not great, so if you’re concerned as a parent, as a healthcare professional, like don’t hesitate.

There’s lots of eye doctors out there, optometrists and ophthalmologists, who can do a very good eye exam, check [00:39:00] refractive error. So that’s what I got. Those are the, those are the things. Uh, so I’ll just run through those again real quick. If I come up with more, I’ll, I’ll add them in a later episode, but blinking, eye rubbing, spots on the white part of the eye, unequal pupils, Crustiness, goopiness, tearing of the eyes, misaligned eye, strabismus, and then like head tilting, head turning, covering an eye, that kind of thing.

All right, try not to ignore those, like take them seriously. You can watch a little bit, see how it goes, like with like eye crusting and gooping, but do not hesitate to get an appointment, see a doctor. So thank you all for listening. That’s our episode of Knock Knock Eye for today. Thank you to my hosts.

My host. Thank you to me. Thank you to me, your host. Thanks to my producers Rob [00:40:00] Goldman, Aron Korney, Shahnti Brooke, editor and engineer Jason Portizo, music By the way, I met Jason for the first time at our DC show Wonderful guy. It’s amazing. You work with people in this day and age, uh, for years and you never actually meet them.

But I finally got to meet our, our, uh, one of our producers, um, our editor and our music is by Omer, Omer Ben Zvi. So thank you all for listening. Again, email me if you want to get ahold of me. Uh, if I screwed anything up, that was my phone that was just going off. Uh, if you have any suggestions, Topics you want to hear, uh, anything I said that was wrong that you want to correct me on.

I’m all ears, definitely, and all eyes. Uh, and so knock, knock, hi at human content. com. Again, I also read the YouTube comments when these are posted. All right, so go to our YouTube channel at Glockenfleckens. Leave a comment. Tell me what you think. I’d love to hear you guys feedback. It’s good. It helps me.

It helps the show. [00:41:00] Uh, alright, so that’s it for today. We’ll see you next time. Knock, knock. I is a human content production. Goodbye.