“What’s the strangest eye problem you know?” I pose the question, in bad Spanish, to a brilliant medical professional one evening over small plates. It turns out to be the furthest thing from polite dinner conversation.
Doctor Sylvia practices as a retina specialist in a Colombian city near the border with Venezuela. She’s in Bogotá for a convention of peers in the eye care business … though other professionals say Dra. Sylvia has few peers.
The doctor puts down her fork and uncorks a doozy of a case. “A tarantula hair inside the eye,” she says. That’s the strangest.
You can look it up. Spider hairs in the eye turn out to be fairly common … at least according to the worldwide (dare I write it?) web. One 2011 article in Case Reports in Ophthalmology, tells of a 16-year-old boy who liked to let his pet tarantula crawl over his face. During one spidery stroll, the boy felt his eye burn. He snatched the big spider away and rubbed the pain, but got no relief … and he felt no relief for the next six weeks. He finally went to a doctor in Salt Lake City, who removed 16 tiny tarantula hairs with jeweler forceps and treated the eyeball with steroid drops.
It turns out that tarantulas have a secret weapon: urticating hairs. (Ouch! It ‘Urts!) It also means these creative creatures have evolved a way to blast tiny barbed hairs from their abdomens into the flesh (or eyes) of their enemies, including 16-year-old boys with tarantula face fetishes.
Doctor Sylvia told me then of the case she knew, and it proved even stranger.
At another eye conference, doctors revealed what happened when another man merely touched a tarantula. A velvety hair from the abdomen of the arachnid pierced a finger, then log-flumed through blood vessels all the way to the eyeball. The spider hair entered the orb and settled to rest, prickling the aqueous humor (the fluid that fills the eye) enough to send the patient to an ophthalmologist. An exam showed—voila!—a rare case of tarantula eyeball.
Another Bogotá doctor I know—let’s call her Doctor A—works right now with a patient condition that’s far more worrisome.
Don Rafael trains horses in the green Sabana section outside the capital city. The horseman practices a trade based on ranchero traditions made famous in the great flat part of Colombia called Los Llanos. Think of the Great Plains of the United States, only with sweltering tropical temperatures. (The Amazon Basin starts south of here.) Vaqueros spend their days rounding up cattle in Los Llanos, and their skill with horses is legendary in Latin America.
The horse whisperer first appeared in Doctor A’s examining room in obvious distress, referred from the ranch where he works with ultra-expensive Arabian ponies bred for polo and jet-setter entertainment.
Doctor A has seen a lot in her practice, but this eye shocked her. Don Rafael’s eyeball was filled with … pus. And the doctor found something on the surface of the eye she’d never seen.
Her first thought, going far back into her medical school textbooks, seemed like something from science fiction—an amoeba. Doctor A had a hunch, even though it was impossible without tests to be sure.
Amoebae! These primitive one-celled organisms can plague eye doctors. They have somehow evolved the ability to hide themselves from detection, turning from visible organisms that live … and feed on … the eye tissues to little cysts that resist detection by even the most modern diagnostics.
The thing in the patient’s eye could also have been bacteria, treatable by different drugs. Or was it a fungus, an ocular invader sometimes hard to distinguish from an amoeba? Or maybe a virus, yet another chameleonic customer tough to diagnose without special tests?
The good doctor ordered tests, some of which took many days to complete. She also worked through weekends, seeing the patient daily, treating multiple possible causes at once. She obsessed over this case, not least because of the patient’s constant pain. The doctor even monitored Don Rafael’s progress from halfway across the country during a long-scheduled family trip in Easter week. While she traveled, she put the patient under the care of a widely respected expert on rare eye amoebae and their treatments.
The patient showed progress. The eyeball cleared of pus. The visual acuity sharpened. Still, the pain and the eye’s irritation persisted. It grew so bad that distress calls came at dawn after sleepless nights, and late on weekends. Doctor A combed the literature on eye amoebae and fungi, plus other ocular culprits. What on earth was this miniature monster? Frustratingly, lab tests proved inconclusive.
She reached out for help, taking the patient to a meeting of corneal experts, men and women with broad experience in just about anything that happens to an eyeball. As soon as these esteemed physicians saw Don Rafael, they reached loud, unanimous consensus. “Fungal infection,” they insisted. “No other possible diagnosis.”
The venerated amoeba expert sat quietly in the room that night. The patient and Doctor A went away. The next day, she began treatments for fungal eye infection. Don Rafael got worse. She immediately switched back to amoeba treatment. He got better, but the eye didn’t completely heal.
And so it went. When one regimen brought slight progress, some setback ensued. With an improvement in visual acuity, intense pain returned. Don Rafael took two steps forward, one step back.
Matters took on a new perspective with a news story out of Alabama about a young Crimson Tide player sidelined from spring training … and sidelined from normal life … for the past six months by what a journalist termed “an eye-eating amoeba.” This poor athlete with a promising career now faced risky eye surgery. Without it, he faced even worse.
Don Rafael somehow, somewhere, had picked up an eye invader much more dangerous than a tarantula hair. What was it? Where did he get it? A splash of water from a horse trough? Rain dripping off a rooftop? A bad moment in a Colombian stream?
Every doctor will tell you that sometimes, once or twice in a career, he or she confronts a case that confounds. In this one, Doctor A valiantly continues treatments based on her best intuition and knowledge. Her exhaustive treatments have been free, by the way – her patient has no money. She’s not sure she’s winning.
Yet slowly, day by day, Don Rafael shows improvement. Doctor A is treating, at times, two possible freakish eye problems at once: fungus and amoeba. She sensibly, professionally, navigates a loud chorus of forceful, cock-sure opinions on what’s wrong with her poor patient.
Will she ever benefit from an absolute diagnosis on what’s living in the eye of the horse whisperer? Probably not, not even in this country of prideful excellence in eye care. (A Colombian doctor invented world-famous Lasik surgery, back in the 1950s.) Doctor A will almost surely one day present this strange case at a conference like the one where Doctor Sylvia learned about a tarantula hair inside a human eye.
It’s a tough way for a horse whisperer to become famous.
Photo: Hamish Irvine, CC-BY
Charles McNair is Paste’s Books Editor emeritus. He served the magazine as writer, critic and editor from 2005-2015.