Another true story from Dr. Hearing:

The last Wednesday and Thursday of each July is a national holiday for my family and me.  It is the Florida’s sport divers’ mini lobster season- a two-day head-start on the commercial harvest of Florida lobster. This past July, my family travelled with my brother and his family to Long Key, Florida. There we stayed at the ZANE GREY INN, a group of eight pastel yellow island-style townhouses, that each share a long common boat dock, pool and barbecue area. The Inn is nestled in lush tropical landscaping, typical of the beautiful Florida Keys.

We comprised a group of eight veteran boaters and lobster divers, all on the same mission to “limit out” on Florida lobster for the two-day mini season.  At 5 a.m. on Wednesday while it was still very dark, all the boats left the docks, racing to get into position at their favorite dive spots for the 6:10 a.m. start of mini season in Monroe County- exactly one hour prior to the published sunrise. Our boat’s “limit”, based on the number of licensed divers, was 36 lobsters each day for the two-day season.

At precisely 6:10 a.m., we hit the water.  The lobsters were everywhere! Reaching our daily “limit” did not take long and shortly after 8 a.m., “limited out” and hungry, we were on our way home back to the docks.  After being stopped by the marine patrol at the docks and checked for safety gear, lobster licenses, size & quantity of lobster, we were on our way for breakfast: eggs, bacon and cheese (a rare exception to my steadfast diet of oatmeal, tuna fish, raw fruits and vegetables).

As the morning progressed, one by one the boats came in- all had met their limits.  By 2 p.m., all boats but one were back at the Inn dock and they all had “limited out”.  It was around 4 p.m. when the last boat wandered in.  Due to numerous problems, they did not have a good start and had only caught a few lobsters. We soon found out that they were even planning on cancelling the rest of their vacation and returning home. They told us that night one of their divers, a fireman from the west coast of Florida, had a developed a serious eye problem that morning.

Though normally on vacation I try not to reveal my occupation, I said “Well, I’m actually an eye doctor. What can I do to help you? Let’s start with: what’s going on?”  The fireman told me that he had dived down to 60 feet, and all of a sudden, one of his eyes went blurry.  He tried the same dive several times, and each time that eye would go completely blurry.  Once he reached surface, however, his vision would return to normal.  The fireman also told me that he was using a new dive mask that was giving him “mask squeeze” on each attempt to get to 60 feet.  Now, the pressure at 66 feet is approximately four times that of the surface, but the problem was still unclear as he told me his flawless medical history. He told me that he had undergone LASIK (corrective eye) surgery three to four years before, but had never experienced any vision problems. Instinct kicked in and I quickly grabbed my dive light to check his pupils and visual fields, only to find that his vision appeared to be normal.

I then called one of my colleagues back at the offices of Visual Health. I told him that the dives had gone well and that we had hauled in a great catch. I then explained the fireman’s situation and asked for some advice. We seemed to come to the consensus that it was likely not an eye problem and was potentially a medical problem, so we needed to have his blood pressure checked as well as a full medical checkup- a 20 mile trip to the urgent care center was in order. Before he left, I said “stop by the dive shop and get a new mask too while you are at it”.

As he drove away, I started thinking. Having 40 years of scuba diving experience with nearly 1500 dives under my belt and 30 years of medical practice, I hadn’t seen or heard of a problem like this one before, but I was sure that I could get to the bottom of it. I started reviewing additional literature online and I called DAN, Divers Alert Network, at Duke University Medical School. There, they have a research and clinical department specializing in Diving Medicine. They have reported a few incidents of blurred vision following a mask squeeze with patients that had LASIK.  They had theorized that either a small amount of fluid or air formed at the stromal interface of the corneal flap in patients with LASIK and that was likely what was happening in this case.  Of course, they also recommended that the fireman seek appropriate medical care upon his return from his trip.  Feeling much better, I spoke with the fireman and concluded likely he could safely dive the next day and need not ruin their trip.

The fireman and his family had a great day of diving on the second day of lobster mini-season and “limited out”, coming back with a great haul of lobsters. Upon returning home, the fireman’s eye doctor was unable to find anything but perfect vision and healthy eyes. I was very grateful to be able to play a small part in saving their vacation and- as every diver knows, a bad day diving is better than a good day working!

Richard Scott Hearing, O.D., F.A.A.O