Asymptomatic vs. Presymptomatic COVID carriers
OK, our masked heads are reeling. 😷 The WHO released (and then "walked back" on) a statement 2 days ago about how transmission of COVID from asymptomatic carriers is "very rare." So what does that mean? Do we all still need to wear masks or not? Can we lift shelter orders? 🤷🏻♀️
So the short answer is - Nothing has changed. The current recommendations still stand: Universal masking is still recommended 😷; we still need to wash our hands 🧼; and we still need to practice social distancing.
The key word here is "asymptomatic" - which refers to people who carry the virus 🦠 but exhibit no symptoms (and never do). My understanding is that the viral load in these patients are too low to produce symptoms and thus too low to be transmitted. These are the people the WHO was referring to in their original statement.
On the other hand, "PREsymptomatic" carriers are those who also carry the virus and are not exhibiting symptoms YET (but WILL, typically within 1 week of exposure 🤒). These patients may feel fine, but can spread the virus rampantly before realizing they are sick. 🦠
And so while asymptotmatic carriers may be less of a worry according to the WHO (great news!), presymptomatic carriers are still a concern, which is why universal masking and social distancing are still so so important for the protection of our communities and loved ones. ❤️
“What is Ophthalmology?”
A new follower messaged me the other day, "What is ophthalmology?" 👁 Sometimes I forget that not everyone knows exactly what I do, so here goes!
An ophthalmologist is a medical doctor 👩🏻⚕️ who has completed 4 years of undergrad, 4 years of medical school, 1 year of internship, 3 years of residency training, and an optional 1-2 years of fellowship (in glaucoma, cornea, oculoplastics, retina, uveitis, pediatrics, or neuro-ophthalmology. Mind-blowing that a little body part has so many subspecialties right? 👁).
On any given day, I can be in clinic seeing patients and helping them with their medications; or doing laser procedures; or in the operating room performing surgeries. I see lots of different eye issues, from dry eye and infections to cataracts and diabetes inside the eyes.
As a glaucoma specialist, the majority of my patients come to me for help managing their eye pressures (I liken glaucoma to systemic hypertension; it's often asymptomatic, but if unmanaged for a long time, can cause major issues like vision loss). I absolutely love what I do. Patients can literally "see" the difference oftentimes 👀 - and it's a privilege to be able to help.
Love what you do. ❤️ Do what you love.
Because those who can see the world are the ones who will change it...
(and yes, that is a Sofia the First remix. 😂👑 “So much to learn and see...!”)
Trauma to the eye
What do you do when you get injured in the eye? In general:
- if you get scratched in the eye (like if debris flies in or someone accidentally pokes you 👈🏼), fight the urge to rub and instead force yourself to blink - this will produce tears 💧 to flush out any debris and moisten your eyes for protection. Thankfully, scratches heal pretty quickly, but you are susceptible to a superimposed bacterial or fungal infection, so see your eye doctor ASAP.
- if you get a chemical in the eye (like pepper spray or tear gas, I go into more detail about these in my post 2 days ago) find a water source and flush it out for at least 10-15 minutes. It may not get all the chemical out (like with pepper spray, you'll need soap or a special wipe to break up the oils), but it'll dilute enough to minimize damage and irritation. Sometimes you can get inflammation in the eye from these chemicals that can affect your vision, so seek medical attention ASAP.
- lastly, if you sustain direct trauma to the eye (i.e. a punch or projectile), again fight the urge to rub or touch it - you can make the injury worse. If there is something stuck in the eye or orbit (around the eye), do NOT remove it. The best thing to do is to keep the eye closed and loosely cover it with a pair of glasses or even a taped on cup🥤(I'm serious, this is in all our textbooks as a treatment!) and seek medical attention ASAP. 🏥
Eye injuries can range from a simple scratch (corneal abrasion) or a broken blood vessel on the surface like a bruise (subconjunctival hemorrhage) to more serious things like bleeding inside (hyphema) or a cut on the eye (laceration or ruptured globe) that can threaten your vision.
As an eye doctor👩🏻⚕️ (and parent), the best treatment for any injury is always prevention, so please please please wear eye protection if you think you will be at risk!
Click HERE for my YouTube explanation
“As a medical student, did you have time for anything else?”
To my surprise, premeds (including high school students!) have been hitting up my inbox 📨 to ask for advice and seek encouragement in their medical school journeys. I love it, but it also makes me feel ooooooold 😂)
One of the most common questions revolves around the amount of work and studying that is involved becoming a physician: “Will I have time for anything else?” 👩🏻⚕️
This is what I tell them: Yes, there will be lots of studying 📖 and late nights. 🌙 So you will have to MAKE the time for your extracurriculars and PROTECT your outside interests. ❤️
In high school and as an undergrad, I loved hanging out with my friends and sorority sisters. I was involved in student government and clubs (sports , dance, and cultural). I also loved tutoring and mentoring other students.
But everyone knew I was a premed, and so when it came time to study and/or head home early from a party, they supported (and some even joined) me. 📚
This balance will also be important in medical school and beyond, where it will be so easy to get caught up in work and the rat race (of grades, residencies, promotions, research, etc).
Don’t forget about YOU - your interests and your passions. Because a happy, fulfilled, and well rounded physician is truly the best kind (and honestly what medical schools, residencies, and fellowships are looking for!).
2 Types of COVID Testing
Peter and I got swabbed for coronavirus 🦠 last week before visiting my parents over the Memorial Day weekend. (As healthcare professionals 🥼 we didn't want to take any chances. We went to a drive thru site, and it took about 4 days for the results.) What exactly does this test tell you and how is it different from the blood test some people get? 🤷🏻♀️
A nasal swab (or mouth swab at some sites) tests for the presence of actual virus particles and can tell you if you have an ACTIVE infection. 🤒 This test is just a moment in time, and even though we were negative, we can still contract the virus in the future. (If the test had been positive, we would have quarantined and expected to develop symptoms in the next few days. 🤧)
The antibody test requires a blood draw 🩸and can tell you if you've had the infection in the PAST (beyond 1-3 weeks). In most cases, having antibodies would grant you immunity to an infection (since your body knows how to fight it), but with COVID19 it is still unclear if that is indeed the case or how long that immunity lasts.
Lastly, if you think you are sick with COVID19 (fevers, coughing, shortness of breath), please call your doctor for instructions and recommendations. The jury is still out whether asymptomatic, low risk people should be tested - while the data would be extremely helpful to figure out how much of the population are/were asymptomatic carriers, many areas/states do not have the capability to test everyone. 🧪
“What are floaters?”
I am asked almost everyday - What are floaters? (by patients, friends, parents... 😉)
Your eyes 👀 are filled with a clear gel called the vitreous. Sometimes, you can get opacities in this gel, which you will see as floaters. People usually describe them as bugs 🐝 or webs 🕸, but they can come in all sorts of shapes and sizes. (I had one patient describe his to me as a "UFO marshmallow" ☁️)
Most of the time, these floaters are benign, caused by age related proteins. But once in a while, they can be caused by blood or other issues inside the eye, so definitely let your eye doctor 👩🏻⚕️ know if you develop any!