Hey, Mazda!” a senior ophthalmologist called me in the middle of a bustling OPD. “I need you to see a patient for me today,” she insisted. I never say no to see a patient, no matter how busy I am, but out of curiosity, I asked what the urgency was. “This 35-year-old boy came to me yesterday to change his glasses,” she began. I later learned that she’d called him a boy because she’d known him since he was one. “He said he felt his eye power needed a correction because he couldn’t see clearly. When I examined him, his eyes were fine, but when I looked inside with my fundoscope, the optic nerves looked swollen–almost like they were on fire!” she exclaimed. She was describing a condition where raised pressure inside the brain transmits on to the eye nerves, converting a pale off-white nerve into a scarlet haze. This appearance is because of the tiny haemorrhages within the minuscule vessels inside the nerve head that rupture from the raised pressure.
 
“Did you get an MRI of the brain done?” I inquired. “I sure did,” she said with glee, having discovered the source of his raised intracranial pressure. Oftentimes, the source of an eye problem is in the brain, and it requires an astute ophthalmologist to decipher it. “There is a 2-cm colloid cyst within the third ventricle blocking the CSF pathway and causing hydrocephalus,” she read from the report. CSF is cerebrospinal fluid, responsible for providing nourishment and protection to the brain. “Send him over,” I requested, and within a couple of hours, he was sitting in front of me in my clinic with his father. 

Rehan was gentle-mannered, dressed in a striped shirt and baggy white trousers that made him look a little older than he was. His father sat stoically next to him, silently awaiting my verdict. “I have been experiencing headaches, but ignoring them. I thought it was because of my blurry vision,” he spoke, his forlorn look forbearing his folly. “He even fainted once briefly, but we thought it was because he hadn’t eaten anything,” his father interjected.