The Ultimate Guide to Optometry Clinical Analogies

In my mind, analogies are often a great way to explain exam information to patients. Therefore, some colleagues and I put together a list of a few of our favorite analogies – with a NGO twist, of course!

The eye is like a camera

A classic analogy that relates the camera lens to the crystalline lens, and the camera film to the retina.

Effective? For now. We’ll see how this analogy transpires as the traditional camera is phased out by “smart” phones. Will younger generations understand this analogy? Use it while it’s still relevant.

 

The optic nerve head is like a doughnut

Although a complex condition, this particular analogy is useful when trying to explain the change in cup-to-disc ratio that occurs in glaucoma – as long as your patient’s stomach isn’t growling!

 

Cataracts are like looking through a dirty window/ windshield

As soon as you mention this one, patients immediately understand and will nod their head in approval. This analogy can really help your patients grasp the simple concept.

However, you might want to steer clear of this analogy if your patient refers to cataracts as “cadillacs.” Vrooom Vrooom! 

 

Retinal lattice is like stretching saran wrap

“The nearsighted eye is physically larger than the average eye, therefore, the retinal tissue can be stretched thin (lattice). If stretched enough, it can develop little holes and/or tears – increasing the risk of it detaching completely. Just like slowly pulling on saran wrap – which gets thin first and then breaks if you keep pulling. ” –  Erik Mothersbaugh O.D.

Your patients will never look at saran wrap the same again…

 

The teeter totter (or seesaw) approach – over refracting a multifocal contact lens patient

An effective visual to use when trying to explain a multifocal contact lens over refraction. Too much or too little power, one way or the other, will leave them unhappy. Subsequently, “balancing the teeter totter” to find their most “functional” vision is the goal.

They’ve hit presbyopia and you’re talking about elementary school recess activities….great!

 

Multifocal contacts are like the Target logo

Courtney Dryer, O.D. exclusive, this analogy is for those overachieving patients who are baffeled by how these lenses work…

The real question is, if you work in a Target optical, do you get a bonus?!? #internalmarketing

 

The optic nerve connects the eye to the brain like a cable connects a TV to the wall

“Your eye is connected to your brain via the optic nerve – just like your TV is connected to the wall via a cable. Yank that cable out of the wall and what happens to your TV signal…? It goes out! Just like damage to your optic nerve can lead to significant damage to your vision!”

Upgrading lens technology is like upgrading your TV or phone

For those patients who are wearing extremely outdated contact lenses…

“Imagine you’re walking into Best Buy and you’re looking to purchase a new TV. As you approach the TV section, all you see is HD flat screens for sale. What you are wearing is essentially synonymous with  a “box television” – old, outdated and almost antique. I’d like to fit you into a lens that is virtually like an HD television – designed with the newest technology to ensure superior vision, comfort and safety. There is a reason Best Buy doesn’t carry box televisions anymore.”

Meanwhile, your patient is pondering when their next phone upgrade is so they can get the iPhone 6!

 

Glaucoma suspect – “There is smoke but no fire”

“Telling patients that there is smoke but no fire, is a great way to let them know you see signs of a potential problem, but there is no true problem just yet! This raises just enough anxiety to emphasize the fact that additional work up is needed.”

Just be sure to keep a brown paper bag in your exam room in case a panic attack occurs!

 

SPK is like rain on your car windshield

Commonly used by Courtney Dryer, O.D. – who tells her patients that their vision won’t be as clear when they have SPK because light is being distorted by an uneven ocular surface.
Umbrella anyone?

Different brands of contact lenses and artificial tears are like different brands of shoes

Because there isn’t one brand that works for everyone…we have options.

Bonus points if you dance like Macklemore during your exam.

Warm compresses for MGD is like turning butter into oil

A throwback “state of matter” science analogy, frequently used by Antonio Chirumbolo, O.D.

Solid + Heat = Liquid! 

Sleeping in your contacts is essentially like sleeping with a bag over your head

I know, I know, depending on the brand, this is not entirely true. STILL, I personally don’t advocate my patients sleep in their lenses for obvious reasons.

Will they do it – of course! Hence, this scare tactic. I guess I could always show them this…

 

Astigmatism – “your eye is shaped like a football”

Commonly confused as “the stigma”, this is NOT my favorite analogy. I honestly don’t use it and am open to other suggestions!

Plus, many patients can easily confuse it with futbol (AKA soccer) – the most popular sport in the world

Blue blocking lenses are like sunscreen for your eyes

“You put suntan lotion on your skin when you go out in the sun for the day, right? Well if you believe in that, you should be putting on blue light blocking lenses when at the computer. Blue light is the wavelength that is next to UVA – which studies have shown to damage your eyes. So think about putting on “sunscreen for your eyes” next time you are at the computer.” – Matt Geller, O.D.
Just don’t give them the idea to put suntan lotion on their actual eyes – that would be BAD!

Contact lenses & bath water

Storing your contacts in the same solution without changing it daily is like taking a bath with the same bath water for a few days. – Samantha Kelly Seltzer

Cataracts are like convertible car windshields

Do you know how the plastic windshield in a convertible eventually turns yellow and cloudy? That is just like a cataract. The UV light eventually breaks down the material and it becomes hard to see through. And we fix it the same way! We cut it out and put a new piece of plastic in its place. – Ryan Parke Ames

Avastin and Weed-be-gone

Avastin: It is like Weed-be-gone for the eye. – Ryan Parke Ames

AREDS is Rustolium

AREDS: It is Rustolium for your macula. AMD is an oxidative process. We need to slow down the rust, that is why you need to take these ANTI-oxidants. -Ryan Parke Ames

Contact Lenses & Milk

I only wear my contacts once or twice a week so I don’t throw them away every month.” I like to use the milk analogy “if you had a gallon of milk in your refrigerator that expired a month ago, but you only drank one or two glasses, would you still drink that milk? – Lisa Harp McAllister

Polarized glasses lenses & venetian blinds

Polarized lenses are like Venetian blinds. They don’t allow all light waves to enter. – Nancy Kirsh

Glaucoma & tea cup saucers

Optic nerve cupping is like measuring the saucer area around its teacup, how much saucer area surround the teacup. – Jannell Cuddy

Contact lens overwear & running red lights

When people over wear their contact lenses (such as wearing their two week lenses a month… or more likely, until they are uncomfortable), it’s kind of like running a red light with their car. You might run a red light many times and get away with it, but the one time you get hit, you’ll wish you didn’t do that. Do you really want to take that chance with your eyes? – Robert Kessen, O.D.

Macular degeneration & overexposed film

I worked with a doctor who often explained early macular changes as the film in the camera being overexposed/worn out. – Megan Andrews

Retinal nevus & the dermatologist

When I am explaining a choroidal nevus or “freckle” I tell patients that just as a dermatologist keeps an eye on freckles/moles/other pigmented areas of the skin for changes in size, shape, or appearance, we do the same thing with freckles in the back of theeye. – Megan Andrews

SPK & expressway potholes

Dry eye/SPK to your vision are like a pothole filled on ramp to the expressway; scattering light during the transition to focusing properly on the back of the eye. – Patrick M. Meade

Cataracts & Gray Hair

Developing cataracts is like getting gray hair– it is a natural aging change. Just like grating hairs, some people experiences them earlier than others. I feel that this analogy calms patients down tremendously, as “cataracts” is a buzzword for some serious ocular disease according to some patients. – Jessica Du

Contacts & Strawberry Fuzz

Waiting until your contacts feel bad to replace them is like waiting until the strawberry is covered in fuzz before you decide its not a good idea to eat it. By the time you feel your contacts, you’re feeling the fuzz. – Juawana Hall

Contact lenses & jean sizes

Contact lens powers are like a pair of jeans. They come in step sizes – 2,4,6,8…etc. Sometimes you are a “3” and if you want, you can get your pants customized, but that will cost more! – Gloria Wu

Vitreous & Jello

PVD: The vitreous is like gel in the back of the eye. Imagine jello gelatin in a mold, if you let it sit out for a while it becomes liquid and will pulls away from the mold with gravity.  – Binal Patel

PEK & Sandpaper

PEK: imagine the cornea as a piece of clear glass. Now imagine looking through that glass after being roughened by sandpaper, not as clear right? – Binal Patel

Cataracts, birthdays & wrinkles

Cataracts: they’re like wrinkles, they come with birthdays and everyone will have them eventually. – Binal Patel

Glaucoma & water balloons

Glaucoma is like fluid pressure building inside a water balloon – The drainage system in your eye should act like a sink, where running water exits out the drain. Sometimes, that can get clogged and the fluid has nowhere to go. Now imagine your eye is like a water balloon, and the faucet is constantly on. The fluid pressure builds up until the weakest point gives out, which happens at the optic disc and can cause damage to your vision. – Anita Koo

Steroids & salad dressing

Pred Forte (or substitute any other drug that needs shaking) is like Italian dressing – all the good stuff is at the bottom so don’t forget to shake it before dropping. – Caroline Haberthy

Astigmatism – Ridge vs. Hill

Astigmatism- you’ve got a ridge instead of a hill. Without astigmatism your cornea looks like a hill rising out of your eye, even on all sides. With astigmatism, your cornea looks more like a ridge. with one long shallow curve & 1 one steep curve (insert hand gestures). The 2 different curves cause the light to bend into 2 different points inside your eye. We need to line up your prescription to wherever your ridge is located to bring those points together in order for you to see clearly. – Erin Schoone O.D.

Tonometry & Tire Pressure

In reference to the NCT or tonometer: This machine here tests your eye pressure which is a lot like when you check your tire pressure. When you check your tire pressure you tap the tire to see how firm the tire is, which correlates with the air pressure in the tire. Similarly, I am going to touch your cornea (or blow a puff of air on your eye) to gauge the pressure of your eye. – Charlene Walton

Cataracts & cooking eggs

A cataract in your lens is like cooking an egg, specially the egg whites. When you crack it open, the egg whites are clear. When you throw it into a pan, the egg white goes slowly from clear to translucent, and finally to white. It is no longer clear, but pure white and not see through. This is the cataract. – Michelle Tai

Contact lenses & oil change

Most people schedule oil changes on a regular basis as preventative maintenance so they don’t have engine trouble. Contact lens wearers should do the same to prevent eye trouble. If they wait until they feel the contacts are getting old, they’ve waited too long. – Debbie Siegall

OCT & Layer Cake

For explaining retinal photos vs OCT: Think of it like a layered cake. A retinal photo is like taking a picture of the top of that cake. You can see the decorations on top, but you can’t see all the layers under the frosting. The OCT image allows us to take a picture of all the layers underneath, like if you were to cut a slice of that cake. – Megan Hangartner

LASIK Flap & Your Home’s Roof

LASIK with a microkeratome is like taking the roof off your house, leaving a flap connected on one side, removing the top few layers of bricks and then putting the roof back on. – Tammy Morris

Retinal Sheen & New Cards

When I explain healthy fundus photos to my young patients and they ask what “the shiny part” is in their photos, I describe their retinas like a shiny new car and they lose that shiny reflection over time. – Jeanette Strommen, O.D.

Cataracts & M&Ms

In trying to explain cataracts. Your lens is like a peanut M & M. The nucleus is like the peanut, the cortex is like the chocolate, and the capsule is like the hard shell. If you have a nuclear cataract, your “peanut” is cloudy!. – Richard Katz, O.D.

RCE & Wallpaper

My favourite analogy is that RCE is like wallpaper. If a piece of your wallpaper peels off and you try to stick it back down with the same old dried out glue, it might peel off again. – Errin Pfeiffer

90D Lens is the Helicopter

90D is like a helicopter overlooking the neighborhood. When we use the BIO, we are looking into certain homes rather than the entire community–especially those at the edges of the neighborhood. – Naul Paz

How Diabetes affects the eye. Sugars are like cars

Car = glycated RBC, driver = oxygen, road = blood vessels
When there are too many cars(RBCs with sugar exporting oxygen) in one road(blood vessel), road gets congested, traffic stops and now the driver(oxygen) can’t get to work (workplace = organ = eye, etc), construction workers (VEGF’s) quickly build a detour, in order for the drivers to get to work, but the new road is weak because the cement isn’t totally dry(neovascularization)when the road is opened. The drivers use the new road but just creates a mess in the end. (CSME) It then takes emergency crew and time to clean up the mess. (PRP or injections) – Raul Angeles

Progressive Lenses are like Cross Trainers

Progressive lenses are like cross trainers; they’re good for everything. But running shoes are better for running and sandals for the beach. Likewise, you can use progressives at the computer, but computer glasses provide even better vision and comfort. – David Nguyen

About Ryan Corte O.D.

Ryan Corte O.D.

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