Unfaithful (2002)

Other than a brief scene of chemical keratoconjunctivitis in Kickass (hairspray in the eyes), there has been a dearth of eye-related movie content on DVD and in theaters lately.  Since we've covered the tired theme of chemical irritation several times (Bolt, Made of Honor, Did You Hear About the Morgans?), I had to resort to HBO to come through with Unfaithful from 2002, starring Diane Lane, and directed by Adrian Lyne.  Lyne also directed Flashdance, Fatal Attraction, and Indecent Proposal.

I guess marital infidelity flicks are Mr. Lyne's specialty, and Unfaithful depicts a tragic family implosion sparked by adultery.  What appears to be an ideal and secure home life proves stifling for suburban housewife Connie Sumner, and her New England manor and even-keel husband can't compete with the exciting, care-free city life offered by French book dealer, Paul Martel.  You can almost connect the dots here with a standard story about the bored housewife, intriguing foreigner, suspicious husband, private investigator, etc, etc.  There's a shift at the end of the second act that steers the plot in a different direction than I was expecting, and for as standard as the rest of the movie is, the power of the directing and acting ultimately produces something more intriguing than it should be.

The downtown loft-dwelling home wrecker, Paul Martel, has more in his bored-housewife seducing toolbox than just a French accent, toned abs (see photo), and inappropriate public displays of affection.  Among the piles of books in his apartment, there is a copy of a book in Braille in the kitchen, and one of his pick-up techniques involves taking Connie's hands in his and drawing them over the pages as he "reads" the words.  From Wikipedia:

The Braille system is a method that is widely used by blind people to read and write. Braille was devised in 1821 by Louis Braille, a blind Frenchman. Each Braille character or cell is made up of six dot positions, arranged in a rectangle containing two columns of three dots each. A dot may be raised at any of the six positions to form sixty-four (2⁶) possible subsets, including the arrangement in which no dots are raised.

The Braille system was based on a method of communication originally developed by Charles Barbier in response to Napoleon's demand for a code that soldiers could use to communicate silently and without light at night called night writing. Barbier's system was too complex for soldiers to learn, and was rejected by the military. In 1821 he visited the National Institute for the Blind in Paris, France, where he met Louis Braille. Braille identified the major failing of the code, which was that the human finger could not encompass the whole symbol without moving, and so could not move rapidly from one symbol to another. His modification was to use a 6 dot cell — the Braille system — which revolutionized written communication for the blind.

Interestingly, Braille literacy statistics show that 50% of legally blind people were able to read Braille in 1960, and this has dropped to around 10% today.  Technological advances and budgetary constraints have been cited as some possible reasons.  I have never met a visually impaired person who could actually read Braille.  This lack of Braille fluency is kind of reflected in the movie, since Paul Martel (who is not visually impaired, by the way) just makes up what he is "reading" with Connie.

Unfaithful is a well-acted and produced movie, with occasionally nuanced moments that rescue it from a movie-of-the-week descent.  A few scenes of peculiar pacing and heavy-handed directing are balanced by a restrained exploration of motive.  It will remind you of "The Stranger" in a movie form.  Let's give Unfaithful a big Braille B .

Blindsided (2006)

Unlike the similarly titled The Blind Side starring Sandra Bullock, Blindsided is a documentary film full of ophthalmology content.  This 65 minute documentary chronicles 12 year-old Jared Hara's experience with a particularly cruel disease known as Leber's hereditary optic neuropathy, a rare form of vision loss which typically develops in a person's teens or twenties.  From the National Institutes of Health:

These vision problems may begin in one eye or simultaneously in both eyes; if vision loss starts in one eye, the other eye is usually affected within several weeks or months. Over time, vision in both eyes worsens with a severe loss of sharpness (visual acuity) and color vision. This condition mainly affects central vision, which is needed for detailed tasks such as reading, driving, and recognizing faces. Vision loss results from the death of cells in the nerve that relays visual information from the eyes to the brain (the optic nerve). Although central vision gradually improves in a small percentage of cases, in most cases the vision loss is profound and permanent.

In the movie, we see Jared's ophthalmologists,  re-enactments of his exams, and witness his personal struggles with his progressive disorder.  The movie's strength lies in its rendering of how disease affects not only the individual, but also their family and friends.  Leber's hereditary optic neuropathy's basis on mutations in maternally inherited mitochondrial DNA also elicits complex feelings of guilt, blame, and unpredictability within the family.

In many ways, Blindsided (and movies like it) should be required viewing for  medical students.  Not every doctor (or even ophthalmologist) will encounter Leber's hereditary optic neuropathy in their career.  These personalized accounts of illness bring textbook descriptions alive, making obscure and intangible diseases very real.  And of course, feelings of helplessness and desperation in the patient and their family when dealing with medical conditions are something important for every practitioner to remember, even when rushing from one exam room to the next.


Blindsided won Best Documentary at the Idaho International Film Festival in 2006.  It has been showing lately on HBO, and is available on DVD.  As a movie, it relies heavily on Ken Burns-style pan and zooming, with an occasionally distracting soundtrack and some awkward sequence editing.  None of this takes too much away from the power of the story, and its illuminating portrayal of a tenacious victim of optic neuropathy.  Compared to that cloying Sandra Bullock football movie, Blindsided has a hell of a lot more ophthalmology content, and a far more nuanced representation of family dynamics and heroism.  B  .

Hachi: A Dog's Story (2009)

The famous true story of Hachiko, the loyal Japanese dog who awaited his master's return every day at the Shibuya train station, gets a modern makeover starring Richard Gere and Joan Allen.  Sony Pictures Entertainment booted this movie straight to a DVD release (just like the last movie re-make I reviewed, Ice Castles), so you'd expect that it would be pretty bad.  But after watching this one, I was surprised it never got a proper theatrical release.

Is there some rule that dog-centric movies must culminate in ultimate sadness?  Entertainment Weekly's review cites Marley and Me and I Am Legend  as recent examples of this man-dog bond motif.  Gere plays a music professor who stumbles upon the lost puppy, Hachi.  The movie bounces between scenes at the university, the professor's home, and the community of merchants around the commuter train station.  I'll try not to give away anything from this story based on events from the 1920s. but you can bet every effort to squeeze tears from the viewer is exhausted here.

The ophthalmology content involves scenes from Hachi's point of view, and show obvious color perception derangement.  This begs the question: Are dogs really color-blind?  My research took me to Paul Miller's (from University of Wisconsin-Madison's School of Veterinary Medicine) excellent review article Vision in Dogs.  Some selected excerpts:

Color vision in domestic mammals has been the subject of numerous studies with conflicting results.  More recent, well-controlled studies suggest that most domestic mammals possess, and use, color vision... cones constitute less than 10% of the visual streak in the dog, whereas they occupy almost 100% of the human fovea.  Additionally, instead of the three types of cones found in humans with normal color vision, dogs have only two functional cone types.

The article goes on to state that dogs lack or do not use "green" cones, and confuse red and green colors.  The canine visible spectrum is divided in the violet and greenish-yellow ranges.  Additionally, dog discrimination of closely related shades of grey is thought to be superior to that of a human.

Despite its manipulative tear-jerking stunts, Hachi tells a compelling story with likable characters and strong actors.  The train station scenes and season changes are very appealing and capture a strong sense of place.  The dog point-of-view scenes accurately reflect current thinking in canine veterinary ophthalmology, depicting a desaturated and altered color spectrum, but not a total lack of color perception.  I think this movie could have enjoyed modest success at the box office, and I reward this dog DVD with a solid B .

Ice Castles (2010)

Following occipital lobe trauma from an ice-skating mishap, figure skater Lexi Winston suffers cortical visual impairment.  You might think this sort of devastating injury would be career-ending, but Lexi and her plucky hockey-star boyfriend Nick set out to prove us wrong.

Normally I might include a bunch of "Spoiler Alert" tags on the plot summary, but this Ice Castles is actually a re-make of the Ice Castles from 1978.  C'mon, you remember tearing up hearing that Academy Award winning song "Theme from Ice Castles (Through the Eyes of Love)", don't you?  The 2010 movie serves up the modern, requisite syncopated re-make of the song, with hyper-stylized vocals.

Transient post-concussive visual disturbance is commonly encountered, but Lexi's type of prolonged/permanent vision loss from head trauma is not as common as you might think.  After the accident, we see her imaging evaluation in an older model General Electric MRI scanner (I think).  While standing in the radiology control room, the matter-of-fact physician counsels Lexi's father about the poor prognosis, advising him to take her home and prepare her for the difficult transition to a life of low vision.

These types of consultations are not normally done while standing in a control room, and in fact, the radiologists and technicians usually don't like it when non-radiologists hang out in there, let alone the family member of a patient.  Also, the doctor's assessment of Lexi's vision as "light perception" is clearly inaccurate, since Lexi's point-of-view shots suggest her ability to discriminate some shapes and movement.

Ice Castles didn't get a theatrical release, instead going straight to DVD with its release timed for the winter Olympics.  Despite some likable personalities and good skating cinematography, there is some seriously wobbly acting and an overall dingy look to the movie.  This one gets a C - , but worth a look if you have a special interest in figure skating, traumatic brain injury, or if you are a 13 year old girl.

Tidbits from 2010

There hasn't been enough eye-related content in a single film to warrant its own entry, but I think we have enough piecemeal content from a few current movies to make a mash-up post.

Sherolock Holmes - Did you know that the author, Sir Arthur Conan Doyle, received a medical degree from the University of Edinburgh in 1885, and later studied ophthalmology in Vienna?  His failure to develop a successful ophthalmology practice in London allowed him to use his spare time to write "A Study in Scarlet", which introduced the character Sherlock Holmes.

The Princess and the Frog - In this Jazz Age fairy tale, Mama Odie is a 200 year old voodoo queen afflicted with bilateral blindness.  The etiology of her ocular condition remains unspecified in the movie.  Given her age and ethnicity, I would list glaucoma, cataracts, and age-related macular degeneration as contenders.  I actually saw this movie with Sydney and her cousin, and I would give it a B+ .  The character Mama Odie has generated a bit of controversy- check out this quote and link from Movie Line:

Meet Mama Odie, the blind, 200-year-old “magical fairy godmother” with a “seeing-eye snake” who might have easily been the mascot for popular turn-of-the-century pantry product, Mama Odie’s Sambocakes and Waffle Batter.

Did You Hear About the Morgans? - Chances are nil that I will watch this abortion of a movie (at least in the theater), but the previews show scenes of Hugh Grant spraying himself in the face with bear repellent.  We've covered ocular pepper spray injuries here a few times already, but I was interested to read the claim that "bear repellent is the only proven way to prevent a grizzly bear attack. In fact, bear spray has a 90% success rate in preventing injury, making it more effective than guns in deterring an aggressive grizzly bear."

... and finally,

The Blind Side -  Despite the title, let me give you fans of ophthalmology in film a heads-up- this movie probably contains little to no eye-related content.  The term "blind side" in football refers to the side opposite the direction a player is facing.  For example, when a right-handed quarterback sets up for a pass, the left tackle is responsible for protecting his blind side.  I haven't seen the movie, but I have heard good things from people.  Wussy people.

OK peeps, that's your round-up for this month.  Happy viewing!

Ninja Assassin (2009)

Attempting to catalog the ocular and periorbital trauma in the ultra-violent Ninja Assassin would be as tedious as estimating the total blood loss in the movie. One particular injury, though, bears mentioning for its graphic depiction and very realistic post-traumatic appearance.

I don't think I'll be ruining anyone's movie-going experience by describing the plot, which involves the standard outline of an orphan, Raizo, being inducted into a grueling martial arts training regimen. The story gets told in a flashback style, reminding me a lot of David Carradine's TV show Kung Fu. Throw in the requisite rivalry with a fellow pupil, and the student-versus-master storylines, add several hundred gallons of stage blood, and you have a pretty good idea of what Ninja Assassin is all about.

OK, on to what you have all been waiting for: the eye injury. Sho Kosugi, the godfather of all ninja movies, plays Ozuno, the leader of the ruthless clan. He sustains a facial trauma and penetrating eye injury delivered by a Kusarigama, a traditional Japanese weapon with a sickle on a metal chain, with a weight on the end. Many years later, convincingly rendered evidence of Ozuno's injuries are seen, including eyelid and corneal scarring. Interestingly, Ozuno's magic regenerative ninja healing powers don't seem to work on his right eye. Also, it seems the vision loss in his right eye does not hamper his incredible ninja skills in the least.

Here is a resource for living well with vision in one eye.

And here's an eye fact from a 2005 article on eye injury from the Archives of Ophthalmology:

In the United States in 2001, an estimated 1,990,872 (6.98 per 1000 population) individuals experienced an eye injury requiring treatment in an emergency room, inpatient or outpatient facility, or private physician’s office.

I can't really objectively assess a movie like Ninja Assassin, since I spent a big part of my childhood watching ninjas in movies and on TV, reading about ninjas, and pretending to be a ninja. For me, this was a hugely enjoyable movie-going experience, full of stylized martial arts and weaponry. The final cinematic fight scene alone is worth the price of admission. For those concerned with nuances like coherent plot, continuity, or believable dialogue, Ninja Assassin will surely disappoint. For everyone else, this movie gets an A - .