Injury Duty - An Eye For An Eye lyrics

A lot has been made of boxer Antonio Margarito's eye surgery going into his rematch with Miguel Cotto this past December 3rd, 2011, and rightfully so. The eye is a delicate organ and mucking up its function could be devastating to a person's quality of life and livelihood. Margarito underwent two separate surgeries as a result of the beat-down he took in his loss to Manny Pacquiao last year. One surgery involved repair of his orbital fracture (broken eye socket). The second surgery was to remove a cataract and the insertion of an intraocular lens (IOL), which was done just this past May. Both injuries were to his right eye. In this edition of “Hurt-Locker,” we'll take an in depth look at what cataracts are, how we get them and specifically how Margarito was treated. (And if you missed the fight, don't trip. We have the stoppage for you queued and ready to watch…) The Basics: The eye is complex, but amazing. To understand the basics there are a few parts of the human-eye you're going to want to get to know a bit better: The Globe: This one is obvious. The globe is fancy talk for “eye-ball”. The outer white of the eye is the sclera, and is the main layer that helps hold the eye's shape. Everything that looks like empty space is actually filled with a fluid known as aqueous humor. The Cornea: Think of the cornea as a clear dome that sits at the front of the eye. It's the first layer that light (which is what makes up all that you see) pa**es through on its way to the back of your eye. The cornea has a thin layer of transparent epithelium (clear cells) that your body is constantly replacing to keep the surface clear and clean with every blink. The Iris: The iris is the part of your eye that has color (For example, if someone says to you “You have brown eyes”, it's your iris they're talking about. But if they tell you you're a “brown noser”, that means something totally different). The iris has an opening in its center (the pupil), and its job is to control the amount of light pa**ing through, and it does that by changing sizes. While you're asleep, your iris isn't seeing much light, so it opens really wide to take in whatever light it can scrounge up. You ever notice when somebody flips a light on in the middle of the night, you open your eyes and you can't see much?! You turn your head away from the light, close your eyes, or throw your hand over your face to block the light out, right? That's because your iris is allowing too much light in. After a few seconds, it gets down to the right size, your lens focuses, and now you can see the jerk that dared disturb your beauty sleep! The Lens: The lens is the part of your eye that focuses the light to the back of your eye (the retina) to give you a clear, crisp image of what you're looking at. Your lens is constantly working while you're looking at things, here's a simple example: Hold your hand up about six inches from your face. Focus in on your palm. Is it clear? Good. Now through your peripheral vision, notice how everything behind your hand is a little blurry? That's because your lens is literally being pulled by a tiny muscle in your eye called a ciliary body. The lens itself is made up of mostly water and proteins. If you think of your lens like a clear shower door, and think of soapsuds as the protein, after many years of use those suds become soap-scum. That's sort of what happens to the proteins in our lenses, they clump together and cloud the lens and this clouding forms what are called cataracts. The Retina: The retina is a light-sensitive tissue that lines the inner surface of your eye. The light that is focused on to it by the lens (think of the retina as a blank movie or projector screen, and your lens as part of the projector showing the movie). In a process beyond what we're going to cover here, the light hitting the retina sets off a bunch of chemical and electrical actions that fire off different nerves, which send messages to the part of your brain what then decodes it all and gives you the images you see. More About Cataracts: Cataracts(http://i1218.photobucket.com/albums/dd402/InjuryDuty/CataractID.jpg)develop for a variety of reasons, including long-term exposure to ultraviolet light (sun-light, tanning beds etc.), exposure to radiation, secondary effects of diseases such as diabetes, hypertension (high blood pressure), advanced age, or trauma (which is the likely cause in Margarito's case) [Types Of Cataracts](): Most cataracts are related to aging, there are other types of cataract: Secondary cataract: Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes and hypertension (high blood pressure). Some studies have also linked cataracts to steroid use (you listening, Shane Mosely?). Traumatic cataract: Cataracts can develop after an eye injury, sometimes they can take years to form. Congenital cataract: Some babies are born with cataracts or develop them very early in their lives, often in both eyes. Radiation cataract: Cataracts can develop after exposure to some types of radiation, including excessive sunlight exposure (so remember those shades or hats with a brim). Injury-Duty Insight: Research has shown that by the age 80, more than half of all Americans either have a cataract or have had cataract surgery. Margarito however, was only 33 when his developed. How are cataracts treated?: Some of the early symptoms of cataracts are fairly manageable with things like better eyegla**es, brighter lighting, anti-glare sungla**es, or magnifying lenses. If these things don't get the job done, surgery is the only option. What are the different types of cataract surgery? Surgery involves removing the cloudy lens and replacing it with an artificial lens. There are two most common types of cataract surgery: Phacoemulsification (phaco for short; pronounced fhay-coe): With this technique, a tiny incision (cut) is made on the side of the cornea (the clear, dome-shaped part that covers the front of your eye). Then using a small device that sends out ultrasonic waves is inserted into the cornea to soften the lens so that it can be removed by suction. (If you wanna geek it out and watch our 3D-Animation of the procedure, check out the video below!) Extracapsular surgery: Here, the surgery is pretty much the same as above, except that a larger cut is made in the cornea allowing the surgeon to take the lens out in one whole piece. This style has fallen out of favor because healing time is much longer given the larger cuts and need for stitches, which take a while to heal. Where does the “artificial lens” play in to all of this?: Once the natural lens is removed it's replaced by an artificial lens called an intraocular lens (IOL). There material of the lens may vary, but they're basically all just clear, and made of plastic. Once properly placed, the lens will not require any special care. For those that are not candidates for lens replacement (due to having another eye disease or have problems during surgery), a soft contact lens, or gla**es that provide high magnification, may be used instead. Injury-Duty Insight: After reading all this, it probably seems crazy that anybody would even consider boxing after this type of surgery. And, we'd have to agree with you. So, the natural question has to be “How in the world did Margarito get medical clearance to fight?!” But before we offer up our two-cents about that lets take a step back. The surgery itself (IOL implantation) carries the risks a**ociated with most other eye surgeries, such as infection and loosening of the lens. With that said, the risk of the surgery itself doesn't seem to be any more risky than other common eye surgeries. In fact, studies suggest that the procedure is safer than the “laser eye surgery” we all hear so much about. [1] You can be pretty sure that Margarito's doctors pointed this out to the New York State Athletic Commission (NYSAC), too. In June 2011, the American Journal of Ophthalmology (AJO) reported that IOL dislocation after Cataract Surgery is quite low. By reviewing 14,000 Cataract operations, the researchers found the rate of lens implant dislocation to be 0.1% 5 and 10 years after Cataract Surgery. [2] But, many critics feel that these stats came from poorly designed studies, pointing out that most of those patients were 70+ years old and not taking part in high impact sports. They make a point. Problem is, there just aren't enough people as young as Margarito in the same (fight) business who have has this type of surgery for good studies to be designed. However, lack of scientific data suggesting that it was safe to allow a man, who had this surgery to replace a lens that was damaged doing the very thing he was attempting to return to, was not an issue to the NYSAC. I just hope that wasn't the argument the commission accepted as the basis for allowing Margarito to fight. Just because there isn't data to match Margarito's exact demographic doesn't justify sending him back in the ring. As a matter of fact, in October of 2011 the (AJO) published a study saying “…IOL dislocation has been noted to occur more frequently than previously thought” because of external (eg, trauma, eye rubbing) or internal forces. [3] I'm guessing that having Miguel Cotto punch you in the face for nine rounds would qualify as an external force, no? Lastly, you're probably asking, “So what would happen if the lens was knocked out of place in Margarito's eye?” Well, that's a great question, but unfortunately it's a tough one to answer because there are not a ton of cases reported. However, from the few that have been documented, consequences range from nothing at all (the lens is simply put back in place with another surgery), all the way to more severe scenarios like having pieces of the lens forced right through the eye, nerve damage, infections, and rarely (but nonetheless serious) blindness. With the jury still out, I would rather not be the guinea pig being tossed in the ring. I also wouldn't want to be the doctor that was entrusted with a man's life while falling to pressures of big money and politics in professional sports. If you dug what you've read, show some love and follow us on Twitter: @ InjuryDuty References: [1] Charles Bankhead, Staff Writer, MedPage Today; Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner Published: May 12, 2010 http://www.medpagetoday.com/Ophthalmology/RefractiveSurgery/20055 [2] Lens Implant IOL Dislocation Risk http://cataract-surgery-information.blogspot.com/2011/08/lens-implant-iol-dislocation-risk.html [3] Pueringer SL, Hodge DO, Erie JC. Risk of late intraocular lens dislocation after cataract surgery, 1980-2009: a population-based study. Am J Ophthalmol. Oct 2011;152(4):618-23. http://www.ncbi.nlm.nih.gov/pubmed/21683329