Patient, heal thyself. How simple DIY method fixed a complex eye problem

Dr Viswanathan Iyer
One fine day in my clinic, I saw Mr MK, a chirpy 52-year-old man accompanied by his wife and young son. He was referred to me by Dr Anuradha Ayyar, an ophthalmologist who specialises in the intricate plastic and reconstructive surgery of the eye and orbit. The orbit is the cavity or socket in the skull that houses the eye and its appendages.
Typically, a patient who has been meticulously evaluated by a colleague and referred for further care tends to be both a gift and a test at once. Since the patient has already undergone a battery of tests and reached a provisional diagnosis, the further referral is either for reconfirmation of the diagnosis, certain advanced investigations or for definitive treatment. So, when such a patient walks into the clinic, their anticipation from you is bound to be high, as the cross-referral is a testament to the trust placed by the referring colleague.
“Very interesting” is how Dr Anuradha had described Mr MK, who had markedly elevated blood sugar levels and hypertension when he first walked into her hospital on a bright Monday morning. He had recently been discharged from a hospital after receiving a course of steroid and antibiotic injections for protrusion of his left eye.

The oral steroids post discharge had catapulted his blood sugar levels. He had sought the expertise of several eye surgeons for his swollen left eye, and other specialists to manage his blood sugar and thyroid issues. However, despite treatment, his condition had deteriorated, and he now experienced blurred vision.
The scans, when Dr Anuradha examined them, revealed a dilated vein in his eye. Suspecting an abnormal connection of the blood vessels in his brain, she advised him to undergo an MRI scan, which confirmed her hunch. She decided to refer the patient to a brain specialist for treatment.

In the presence of his wife and son, when I examined Mr MK’s scan, it revealed a protrusion of the left eye, along with engorged veins akin to what we observe when we use a tourniquet on the forearm prior to blood sampling. Mr MK appeared deeply perturbed by his condition, if not thoroughly exasperated by the lack of a definitive diagnosis.
I recommended a cerebral angiogram to find the cause of the engorged veins. This is similar to the procedure performed by cardiologists to visualise the blood supply of the heart. The angiogram threw up an abnormal connection between the arteries and veins of the eye’s orbit, resulting in elevated pressure. This pressure impeded the outflow of deoxygenated blood from the eye.

The treatment was to disrupt and delay the blood flow into the eye, promoting the closure of the abnormal connection. While this may sound complex in theory, the solution — as I saw it — was rather simple and practical. Instead of writing down a prescription, I pressed down two fingers on my neck to show the 52-year-old what he must do at home: repeatedly compress an artery in his neck using his fingers.
He diligently performed this manoeuvre to the T for two weeks. A fortnight later, when he returned to my clinic, I didn’t need to see his bloodwork to tell that he was completely cured. The smile of relief on his face reached both the right and the left eye, which was no longer swollen.
For me, the case gives a whole new meaning to the phrase ‘hands-on treatment’. While the road to his diagnosis may have been technically complicated, all it took to restore Mr MK’s vision and spirits was a quick, simple self-treatment. Like many things in the age of information, medical answers too at times rest — quite literally — on our fingertips.
Dr Iyer, a brain and spine surgeon who leads the neurosciences department at Horizon Hospital, spoke to Sharmila Ganesan Ram