Takeaways

• Systemic health shows up in the eyes – From HIV-related Kaposi Sarcoma to chlamydial and gonococcal conjunctivitis, ocular findings often reveal deeper medical conditions.
• Storytelling bridges film and optometry – The Together movie becomes a powerful metaphor for patient care, trauma, and the way eye care professionals interpret complex human experiences.
• Optometrists must ask hard questions – Beyond vision correction, clinicians play a crucial role in screening, detecting, and guiding patients toward urgent systemic care.

Optometry is a profession that continually balances medical science with human experience. In a recent episode of the Reel Eyes Podcast, hosts Dr. Jacob Wilson and Dr. Jacobi Cleaver welcomed guest Dr. Morgan Jones for an unusual yet engaging conversation.

The discussion spanned rare clinical eye cases, such as Tolosa-Hunt syndrome and Kaposi sarcoma, before diving deep into a detailed review of the horror film Together. What began as a movie critique became a broader reflection on trauma, relationships, systemic health, and the eye’s role in revealing more than vision.

Table of ContentsTakeawaysClinical Case Highlights: Lessons Beyond the EyeTolosa-Hunt Syndrome in PracticeKaposi Sarcoma in an HIV PatientPediatric Eye Care: TORCH Screening and Preseptal CellulitisPop Culture Meets Optometry: Reviewing TogetherThe PremiseSymbolism and Clinical ParallelsTrauma, Dependency, and Body HorrorTim’s BackstoryThe Cult ConnectionThe Climax: Merging as OneFrom Film to Clinic: Eye Care LessonsCorneal Contact and Ocular Infection RisksChlamydia ConjunctivitisGonococcal ConjunctivitisClinical Takeaway Clinical Case Highlights: Lessons Beyond the Eye Tolosa-Hunt Syndrome in Practice

Dr. Jones shared the case of a woman in her 40s presenting with severe unilateral eye pain, cranial nerve palsy, and ptosis. After excluding stroke, MS, and tumors, the diagnosis pointed to Tolosa-Hunt syndrome—a rare inflammatory disorder.

The key clinical pearls:

• Optometrists must think systemically when faced with unexplained orbital pain.
• Steroid responsiveness is a hallmark feature.
• Close collaboration with neurology ensures appropriate care.

Kaposi Sarcoma in an HIV Patient

Dr. Cleaver discussed a patient with a history of HIV presenting with Kaposi sarcoma lesions on the eyelids, conjunctiva, and torso. For many clinicians, this remains a rare sight in the modern era of ART.

This case highlighted the importance of:

• Recognizing ocular manifestations of systemic disease.
• Considering patient immune status during ocular assessment.
• Understanding that optometrists may be the first providers to spot systemic pathology.

Pediatric Eye Care: TORCH Screening and Preseptal Cellulitis

Dr. Wilson described evaluating a two-day-old infant for congenital ocular signs of TORCH infections—a high-stakes exam emphasizing the role of pediatric collaboration. Later, he shared diagnosing preseptal cellulitis in an infant outside clinic hours, reflecting the reality that optometrists often serve as first responders for families.

Pop Culture Meets Optometry: Reviewing Together The Premise

Together begins with search dogs discovering ominous cave water that fuses them into a grotesque hybrid creature. Soon, protagonists Millie Tim (David Franco) and Millie (Alison Brie) face career changes, relationship tension, and the cave’s disturbing influence.

Symbolism and Clinical Parallels

• Risky Decisions: Tim’s reckless cave water drinking mirrors patients ignoring red flags.
• Body Horror: Scenes of fusing flesh and hair consumption parallel systemic diseases that rob patients of control.
• Unreliable Perception: Much like complex neuro-ophthalmic cases, the film blurs reality and hallucination.

Trauma, Dependency, and Body Horror Tim’s Backstory

A haunting reveal shows Tim discovering his father’s decomposed body and mother’s psychotic break. This trauma underpins his unhealthy dependency on Millie. For the doctors, it illustrated how patient history often clarifies present dysfunction, much like ocular findings often connect to systemic history.

The Cult Connection

The arrival of Jamie, a teacher with cult ties, deepens the horror. His wedding tape depicts ritual merging, and his references to Greek mythology foreshadow Millie and Tim’s fate. Missing hikers found in grotesque half-merges serve as chilling metaphors for relationships that collapse under pressure.

The Climax: Merging as One

In the film’s climax, Millie and Tim fully morph into one being. What began as relationship dysfunction culminates in literal fusion, with their eyelashes, corneas, and anterior chambers grotesquely uniting.

While unsettling, this scene resonated with the doctors as an exaggerated metaphor for dependency, identity loss, and uncontrolled bodily change—themes optometrists often see in patients navigating vision-threatening disease.

From Film to Clinic: Eye Care Lessons Corneal Contact and Ocular Infection Risks

As the doctors humorously noted, cornea-to-cornea fusion is biologically impossible—but it raised real questions about ocular infection transmission.

Dr. Wilson explained:

“There should never be eye-to-eye contact. The risk of transmitting infections like chlamydia is very real.” Chlamydia Conjunctivitis

The conversation shifted to adult inclusion conjunctivitis, an ocular manifestation of chlamydia. Key points included:

• It often presents as unilateral, watery conjunctivitis with marked papillary response.
• Misdiagnosis as simple conjunctivitis is common, especially when initial antibiotic drops fail.
• Treatment: A one-gram dose of azithromycin is highly effective; doxycycline is an alternative.

Gonococcal Conjunctivitis

In contrast, gonococcal infection presents as the most purulent, aggressive conjunctivitis clinicians will ever see—requiring immediate systemic treatment (ceftriaxone injection) and partner notification.

Clinical Takeaway

Optometrists must remain comfortable initiating difficult conversations about sexual health. As the doctors emphasized, untreated STIs can lead to infertility, systemic morbidity, and vision loss.

“We’re not just treating a red eye—we’re preventing long-term systemic and ocular consequences,” Dr. Cleaver reminded.

This unique episode of the Reel Eyes Podcast highlighted the unexpected but powerful ways clinical practice and cultural narratives intersect. From diagnosing rare neuro-ophthalmic disorders and managing HIV-related ocular disease to critiquing horror cinema, optometrists navigate science, humanity, and storytelling every day.

By reflecting on films like Together, practitioners can better appreciate the symbolic and real-life parallels of dependency, systemic disease, and the importance of thorough clinical care.

Optometry is more than vision—it is about connecting health, culture, and humanity.