Sunday, October 11, 2015

Don't it make my Brown Eyes Blue?

"Eyes are the windows on the soul." Many people have been credited with that quote. Crystal Gayle sang "Don't it Make my Brown Eyes Blue." Bob Marley sang that a man's eye color is irrelevant in his War, lamenting the significance society associates with skin color. Eyes have had their share of attention over the years.

We see a a great many catchy headlines. Let's face it, the writers and editors are skilled at catching our attention. But a story recently posted by Essilor, the "world's leading provider of eyeglass lenses" caught my eye. We have heard a great deal in workers' compensation about pain, and more specifically how to deal with pain. Stories about pain catch my attention.

Well according to Essilor, the color of your eyes is a predictor of how "pain-tolerant" you are. They tout research out of the University of Pittsburgh that they say supports "eye color is related to pre-dispositional traits such as pain-tolerance and alcohol susceptibility." That is a simplification. Eye color does not affect pain. 

Stated more precisely, "the genes that determine your eye color also impact how your body reacts to pain and alcohol." So the color of your eyes are an external evidence that you have certain gene traits. It is these traits that also affect your perception of pain.

Scientists at one time believed humans "had 2 million genes." But more recently, the published belief is that we have "only" about 19,000. Essilor says that "eye color is based on 12 to 13 individual variations in people's genes." One of these genes "is related to darker eyes" and a proteins controlled by that gene "is related to pain" perception.

The researchers at the University of Pittsburgh studied 58 pregnant women. In the field of statistics, that is a very small sample to study. They found "that women with blue or green eyes experienced less pain than women with brown or hazel." The study also concluded that "women with lighter colored eyes also had less anxiety after giving birth and lower rates of post-partum depression," according to the Daily Caller

One of the researchers told MedPageToday that this is "just a pilot study with small number of women." The lead author provided more detail on the methodology of the study. The reaction to pain medication was one of the study factors. They concluded "dark-eyed women had greater pain," according to the study, because of "their increased pain reduction when they were given epidural analgesia." So some portion of the finding is subjective in nature, relying upon the self-reporting of pain and relief from this treatment. 

The lead author also conceded that the pain reduction figures "show a trend," but admitted that "they are not statistically significant." Instead, "there is more of a reduction in pain with the epidural because those with dark eyes appear to have more sensitivity to pain and therefore may get a stronger impact from pain relief treatment." So the gene influence may not be about how we perceive pain, but how susceptible we are to things that relieve pain?

They promise further studies, including "non-pregnant women and would also look at the relationship between eye color and pain among men." This  breadth should help with the author's perception that the current data lacks statistical significance. For such significance, large groups of people from a variety of perspectives will have to be studied in multiple studies. 

An interesting note from the world of modern medicine. How do they come up with these things? Well, one researcher said this idea came from a water-cooler comment about a patient, in which a resident said "see, that woman has brown eyes . . . she is going to be trouble." That points out the value of the perspective that front line observers might bring to a question.

Pain is a an issue in workers' compensation. It will continue to be an issue because injuries result in pain. How we deal with that pain and other symptoms has been opium-focused for the last three decades and the market is looking for other answers. Perhaps a better understanding of how we react to those medications, and why genetically, will help with this. 

We will also see studies of what else influences pain. Last year we heard about the relationship of smoking and pain. It appears that there are many avenues of inquiry that may be relevant to the issue of pain and how we can deal with it, alleviate it, and move forward from it. 

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