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Medical question, sort of....

 
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sandilib



Joined: 09 Jul 2008
Posts: 388
Location: Ontario

PostPosted: Fri Aug 29, 2008 7:44 am    Post subject: Medical question, sort of.... Reply with quote

I started reading "If Angels Burn" by Lynn Viehl, first book of her Darkyn series.

I know there is a doctor on board, as I recall this lady mentioning her profession in a post, but I can't remember her name, and I have a medical question related to IAB.

At the beginning of the book (for those unfamiliar with the story), the heroine, a reconstructive / plastic surgeon, goes to visit one of her patients. This patient has been severely beaten and burned. This is the exact quote from the book:
Quote:
....carefully applied drops of corneal lubricant to the glaring eyes............ The muscles around Luisa's eyes contracted in what would have been a blink if she'd still had eyelids


It is shown in the book that Luisa can see. So here is my question: if she was so burned that her eyelids were gone, wouldn't she be blind too? Wouldn't her eyes have "cooked" so to speak? Sorry, I know it is a bit gruesome (and I do have a problem with that in that book), but this really bothered me. It does not seem logical that Luisa could still have her eyesight.

So anyone with medical knowledge, is that possible? Can your whole face be 3rd degree burned, including your eyelids, and yet you retain your eyesight?

Thanks !
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Susan/DC



Joined: 26 Mar 2007
Posts: 1667

PostPosted: Fri Aug 29, 2008 2:20 pm    Post subject: Reply with quote

It is hard to see how the eyes wouldn't have been injured if she was so badly burned she lost her eyelids. I'm not a doctor, but I think the issue would also be that the patient would go blind because her eyes would dry out. One of the functions of eyelids is to keep tears on our eyes so that the eyes stay moist. I don't see how one could add liquid often enough to replace the function of eyelids; after all, we blink so frequently. But I'm looking forward to hearing from a doctor who may tell us how it could be done.

OTOH, I work with a man who was horribly burned years ago, including on his face, and he can still see. He does have his eyelids, however.
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msaggie



Joined: 22 Mar 2007
Posts: 699

PostPosted: Fri Aug 29, 2008 5:54 pm    Post subject: Re: Medical question, sort of.... Reply with quote

sandilib wrote:
...I know there is a doctor on board, as I recall this lady mentioning her profession in a post, but I can't remember her name, and I have a medical question related to IAB.

At the beginning of the book (for those unfamiliar with the story), the heroine, a reconstructive / plastic surgeon, goes to visit one of her patients. This patient has been severely beaten and burned. This is the exact quote from the book:
Quote:
....carefully applied drops of corneal lubricant to the glaring eyes............ The muscles around Luisa's eyes contracted in what would have been a blink if she'd still had eyelids


It is shown in the book that Luisa can see. So here is my question: if she was so burned that her eyelids were gone, wouldn't she be blind too? Wouldn't her eyes have "cooked" so to speak? Sorry, I know it is a bit gruesome (and I do have a problem with that in that book), but this really bothered me. It does not seem logical that Luisa could still have her eyesight.

So anyone with medical knowledge, is that possible? Can your whole face be 3rd degree burned, including your eyelids, and yet you retain your eyesight?

Thanks !
This may be more up Elle's alley, but I will try to give a quick answer (on behalf of the physicians) and she can correct me if I am wrong. If this person's eyelids are burnt off, then it is very unusual that he/she is still not blind. The damage to the cornea (which is the transparent front part of the eye) would make you blind. So, it's medically not very probable. Patients who are blind because of corneal damage could get a corneal transplant and regain their sight, if the rest of the eye is OK.
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Anne Marble



Joined: 22 Mar 2007
Posts: 606

PostPosted: Sat Aug 30, 2008 2:21 am    Post subject: Re: Medical question, sort of.... Reply with quote

sandilib wrote:
So anyone with medical knowledge, is that possible? Can your whole face be 3rd degree burned, including your eyelids, and yet you retain your eyesight?

Thanks !


I'm no expert, just a Googler. Wink But I did find a reference to a girl who was burned over 90% of her body in 1986 (when she was a little girl). She lost her eyelids -- but she isn't blind. Doctors were expecting loss of vision, she surprised them all:
http://www.lubbockonline.com/stories/052299/reg_052299070.shtml

There is a similar story here:
http://seattlepi.nwsource.com/specials/burn/benarchive.asp

I found a medical abstract about eyelid burns. It seems improved medical treatments have helped doctors prevent blindness in burn victims. The URL is long and funky, but that's OK because it might put you to sleep, anyway. Wink
http://www.plasreconsurg.com/pt/re/prs/abstract.00006534-200003000-00006.htm;jsessionid=L4xJvdQ4vpLnP86WlnbyLVCh0jfvS7HhTC4hWLf3bp6Dvnn1pJ8h!231517226!181195629!8091!-1

By the way, Lynn Viehl has worked in the medical profession (she mentioned emergency room slang and a fellow EMT in some of her blog entries). So she might have seen cases like this first-hand. While Googling this, I learned that J. R. Ward used to be in the medical field, too. Interesting, isn't it? I wonder if that experience drew them both to vampires? Very Happy
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Nana



Joined: 02 Apr 2007
Posts: 948

PostPosted: Sat Aug 30, 2008 4:51 am    Post subject: Reply with quote

I can't speak to burns, but I know from military history that there were multiple examples of German and French soldiers losing eyelids to frostbite in Hitler and Napoleon's Russian campaigns, respectively, and I don't remember any of them being recorded as also being blind.
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MrsFairfax



Joined: 27 Mar 2007
Posts: 1069

PostPosted: Sat Aug 30, 2008 7:52 pm    Post subject: Reply with quote

More anecdotal evidence - The paraprofessional who helped out in my daughter's kindergarten class had been injured by a falling tree crashing through her car windshield during a storm. It destroyed her face. She had to put drops in her eyes frequently, because she could no longer blink. Although, now that I think about it, I'm not sure whether she no longer had eyelids or simply had lost the fine muscle control. (I adore this woman, she's immensely braver than me, and I'm ever thankful that my daughter got to know her and love her, too.)
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sandilib



Joined: 09 Jul 2008
Posts: 388
Location: Ontario

PostPosted: Tue Sep 02, 2008 10:15 am    Post subject: Reply with quote

MrsFairfax wrote:
More anecdotal evidence - The paraprofessional who helped out in my daughter's kindergarten class had been injured by a falling tree crashing through her car windshield during a storm. It destroyed her face. She had to put drops in her eyes frequently, because she could no longer blink. Although, now that I think about it, I'm not sure whether she no longer had eyelids or simply had lost the fine muscle control. (I adore this woman, she's immensely braver than me, and I'm ever thankful that my daughter got to know her and love her, too.)


MrsFairfax, what a wonderful anecdote, very uplifting. I have such admiration for people who have been severely injured and bounce back in the manner you describe. I feel humbled and frankly unworthy when I encounter such people. Here I am complaining because I have terrible headaches, or a bad back, and then I see these people who had to overcome horrendous obstacles. Makes me ashamed..... I truly doubt that I would have their courage....

The human body is amazing. I had an aunt whose blood work was so abnormal that she should have been dead at 20. None of her blood tests ever came back within the "norms", and yet she lived happily and healthily until the ripe age of 89.

Getting back to the quote from the book, logically I cannot accept that Luisa is not blind. But, as real life shows, it might be possible.... I just know that this line truly yanked me out of the story.
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Elle



Joined: 22 Mar 2007
Posts: 106

PostPosted: Wed Sep 03, 2008 10:06 pm    Post subject: Re: Medical question, sort of.... Reply with quote

sandilib wrote:

So anyone with medical knowledge, is that possible? Can your whole face be 3rd degree burned, including your eyelids, and yet you retain your eyesight?
Thanks !


Well, I know much more about eyes than I do about burns, but I would agree with you that facial burns as severe as described in that quote (in which it sounds as though the tissue is not just damaged and contracted but actually absent since one can see the underlying musculature) seem likely to be associated with at least some loss of vision. Even if the eyes themselves were spared from injury during the fire, the concern (as msaggie and Susan/DC have mentioned) is that corneal damage would develop due to severe, chronic exposure since the eyelids are necessary for maintaining a healthy, moist corneal surface. Putting lubricant drops into the eyes is not a bad idea (although not likely to be a task performed by the plastic surgeon herself--LOL!), but it would have to be done very frequently. More likely the cornea would need to be protected with a thick layer of artificial tears ointment and the patient would require a surgical grafting procedure on the eyelids to prevent visual loss due to corneal ulceration and opacification.
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