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Feature Articles: Retinal DiseasesA Window To Your HealthJames Bolling, M.D.
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| Several years ago I walked into an examination room and
introduced myself to a patient whose office chart had been lost. She said, "Dr.
Bolling, I have seen you every year for the past 5 years!" I did not recognize this
woman's face at all. I would have sworn that I had never seen her before. I was
embarrassed and tried to move on with the examination. When I looked at her retina however
I suddenly recognized her! "Oh yes I remember you!" I said. You have diabetes
with just a few superficial retinal hemorrhages but very dilated retinal veins. Suddenly
she seemed very familiar. I did not recognize her face but I recognized her retina immediately. You may think this is strange but I spend a lot of my time with a patient sitting in the dark looking at his or her retina. I don't spend nearly as much time looking at a patient's face. Also keep in mind that retinas are very unique and recognizable. You may remember a scene in the first Star Trek movie where a computer identifies Captain Kirk by scanning his retina. The retina scan actually exists and it is very possible to identify someone from the appearance of the retina. It is analogous to identifying someone from his or her fingerprints. While the retina is a unique identifier of each person, it is much more than that. It is a window to that person's health. We can look directly at the blood vessels in the retina. We can diagnose hypertension, diabetes, carotid artery disease, leukemia, endocarditis, anemia, polycythemia, hyperlipidemia, multiple sclerosis, valvular heart disease, sardoidosis and AIDS to name a few. The retina is part of the brain and can be used to diagnose brain tumors, stroke, sub-arachnoid hemorrhages, neurofibromatosis and other phakomatoses, meningitis, migraine and a number of other diseases. Needless to say I was thrilled when I was invited to coordinate an issue on Retinal Diseases. We are fortunate to have an excellent group of fellowship trained retinal specialists here in northeast Florida. I greatly appreciate the assistance of the Florida Retina Institute, Retina Associates, Shands Jacksonville and Mayo Clinic in preparing this issue. Each of the retina specialists in these groups has done additional fellowship training in retinal diseases after completing their Ophthalmology training. They all limit their practice to the diagnosis and treatment of Retinal diseases and I suspect that from time to time they each recognize a patient not buy their face but by the retina. Did you recognize my picture above?
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The Heart Of The Eye — The Retina
Northeast Florida is truly a fortunate community. It is located in one of the most desirable geographic locations in the world. It is nourished by the Godly golden sun, the majestic St. Johns River and the magnificent, awesome Atlantic Ocean. It is the home of a diverse culture in love with the Jaguars and the sun. Also, it is wealthy with a medical community practicing the highest caliber medicine in almost every known medical specialty. This issue of Jacksonville medicine is a testimony to the work of an excellent and exceptional group of fellowship-trained retinal specialists in the northeast Florida area. These articles are but a drop in a sea of knowledge about retinal diseases, but each author covered his subject in a very eloquent and comprehensive manner. As a cardiologist, I have learned tremendously from these articles and I feel that we, as primary care physicians, owe it to our patients to take a good history and physical with a complete eye examination . We should have a low threshold for referring patients with history and abnormal physical examination to our ophthalmology colleagues. I hope you will enjoy these articles as I did. Jacksonville Medicine / September, 2000What's New
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