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The patient: A man in his 20s in Edinburgh, U.K.

The symptoms: The man visited an eye clinic after noticing floaters — small, dark shapes drifting across his field of vision — along with brief flashes of light in his right eye for six days. He was otherwise healthy and had no history of eye disease, physical trauma to the eye, or drug use. He had mild nearsightedness, for which he wore glasses.

What happened next: Doctors performed a thorough eye exam while the patient wore glasses, finding that his corrected vision measured 6/6 in both eyes, the metric equivalent of 20/20. His eye pressure was also normal.

However, a closer examination of the patient's retinas , the light-sensitive layer lining the back of the eye, revealed significant damage in both eyes, according to a report of the case .

In the right eye, doctors found multiple retinal tears and bruising, as well as a retinal dialysis, a rare type of tear in which the retina begins to separate from its outer edge where it connects to other tissues of the eye. Without treatment, retinal dialysis can progress to full retinal detachment and cause permanent vision loss. The left eye also had bruising and six small, horseshoe-shaped retinal tears: three at the top and three on the side of the retinal tissue.

Since these injuries are typically caused by sudden trauma to the eye ‪—‬ from a punch or sports injury , for instance ‪—‬ doctors revisited the patient's history and asked whether anything unusual had happened involving his eyes.

The patient, described in the case report as a "hesitant historian," later disclosed that he had been using a percussive massage gun directly on and around his eyes for the past three months. He had bought the device himself and used it weekly for several minutes at a time without medical guidance, in an effort to relieve a "feeling of tiredness" in his eyes.

The diagnosis: Doctors concluded that the patient's retinal injuries were most likely caused by this improper use of the massage gun, according to the case report. These devices deliver rapid, high-frequency pulses of pressure that are intended to relieve muscle tension. However, they can cause severe damage to delicate tissues like those found in the eyes.

The eye is filled with a gel-like fluid that helps it maintain its shape. The case report authors suggested that, each time the device put the eye under pressure, it may have briefly distorted the eye's shape. Over time, this repeated stress may have placed strain on the retina, eventually leading to the small tears.

The man's doctors suspected that his use of the massage gun had warped the shape of his eyes, placing pressure on the retinas that led to tearing. (Image credit: Mark Garlick/science Photo Library via Getty images) This pattern of injury was also different from what's seen in typical retinal dialysis cases, they noted. The condition most often occurs in the lower, outer part of the retina, along its bottom edge. In this patient, however, the injury was found in the retina's upper region, which his doctors said may reflect repeated forward pressure from the device rather than a conventional lateral impact, such as blow to the head.

The treatment: Around 8% to 15% of retinal dialysis cases can progress to retinal detachment, which can lead to vision loss. In this case, however, the patient's vision was preserved.

The retinal tears in both eyes were treated with laser therapy; targeted laser burns create scar tissue that helps seal the retina in place and thus prevent fluid from seeping underneath. The right eye's retinal dialysis was treated with "barrier laser therapy," which similarly creates a protective scar around the affected area to reduce the risk of progression.

At a follow-up six months later, the patient's condition remained stable, with no further damage or cataract formation (clouding of the eye's lens). Doctors reported that the positive outcome was "likely due to the patient's prompt presentation soon after noticing symptoms and the immediate initiation of treatment."

What makes the case unique: Eye injuries linked to massage guns are rarely reported. The small number of cases that appear in the medical literature suggest they can sometimes cause serious or permanent damage.

In one such case, a 69-year-old man developed severe eye complications , including lens dislocation and glaucoma (a sudden rise in eye pressure) after using a massage gun near his eye for several weeks. In another case, a 38-year-old woman developed a dense traumatic cataract — a type of cataract that forms due to physical injury — and severe vision loss after using a similar device over her temple and eye region.

The Edinburgh man's case is the first to report retinal dialysis and multiple retinal tears linked to massage gun use. Such injuries are usually associated with high-energy trauma, such as road traffic accidents, sports injuries or a direct blow to the eye, or they occur in people with underlying risk factors, including severe nearsightedness or age-related eye changes, the case report authors noted.

Other dilemmas

After taking a medicine for years, a man suddenly had weird changes in his taste that made food disgusting

Viral infection caused woman not to recognize her own father

Brain scans following a man's hospital visit for leg weakness revealed a surprising finding

In this case, the young man had none of these known risk factors. The extent of the damage in the absence of these risk factors raises concerns about the effects of improper use of massage guns near the eyes, his doctors concluded.

Massage guns are widely sold for at-home use, but there are currently no standardized safety guidelines for using them on or near sensitive areas, such as the eyes. The authors of the case report said the man's case highlights the need for clearer manufacturer warnings and greater awareness of the potential risks of improper massage gun use.

For more intriguing medical cases, check out our Diagnostic Dilemma archives .

This article is for informational purposes only and is not meant to offer medical advice.

Can you guess the diagnosis in these strange medical cases? Find out with our diagnostic dilemma quiz!

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This essay began as a plea which turned out, as desires sometimes do, to be a little psychic (“That woman, I conjured her,” says Gwyneth Paltrow’s overwrought Plath in the failed 2003 biopic Sylvia , discussing Assia Wevill, the infamous “other woman” in the Plath-Hughes marriage disaster). In early March, gearing up to watch The Bride, I wrote a hasty note on my “Loving Sylvia Plath” Substack entreating director Maggie Gyllenhaal to adapt The Bell Jar and give us “the beautiful, disgusting, disturbing film full of poison and puke and violence that it deserves to be.”

The enthusiastic response I received on that usually tepid platform heartened me. People cheered; some hissed. Kathleen Connors, co-author with Sally Bayley of the groundbreaking Eye Rhymes: Sylvia Plath’s Art of the Visual, wondered, “How do you get to her, Emily?” which sent me briefly Googling “Maggie Gyllenhaal contact info” before my return to sanity. Perhaps I would conjure her. Despite my best efforts to disabuse the literary world of its witchy ideas about my favorite writer, the gothy teen who first fell in love with Sylvia’s work in the 90s still lives inside of me. And the truth is, in Plath world, the uncanny abounds. I fingered the jagged slab of concrete I once filched from the basement where Sylvia tried to take her life in August of 1953 and entreated her to hear me. The next day, it was announced that The Bell Jar was being adapted for the movies—by director Sarah Polley and starring Billie Eilish.

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You would think that a writer with Plath’s marketability and staying power would long ago have been seized upon by Hollywood, but Sylvia is famously hard to adapt. Other than the handful of scholarly documentaries about her ( this one from the Annenberg Center in 1989 contains haunting performances of Plath’s poems by the actress Ellen Tobie; a more recent BBC documentary called Inside The Bell Jar includes revealing interviews with Plath’s closest childhood friends), Plath is either absent from cinema or badly portrayed, with emphasis on caricature over character. In the aforementioned Sylvia, Gwyneth Paltrow stares moodily into the void or shrieks at Daniel Craig’s skulking Hughes for coming home late. In a 2021 episode of Dickinson, a show that excelled at lending nuance to another leading American woman poet, the usually excellent Chloe Fineman gave us a Plath whose primary inspiration seemed to be Pia Zadora’s beatnik in John Waters’ Hairspray (“When I get high, I am Odetta!” Dig.).

And while “They should never make a movie of The Bell Jar ” is an apparently universally acknowledged internet truth, it doesn’t account for the fact that a movie of The Bell Jar already exists. Ted Hughes sold the film rights to the book sometime in the mid-1970s; it was released by Avco Embassy Pictures on March 21, 1979 to universal disclaim (check out this episode of Siskel and Ebert where Gene Siskel calls the film “a cross between All My Children and Hee Haw ”).

Bringing Plath to the screen has the power to show her for what she was, what she showed us—a white woman being exploited who was nonetheless capitalizing on her racial power in a moment when women felt especially powerless.

It’s also a sentiment with which I profoundly disagree. The Bell Jar’s deep interiority; its repeated veering into elaborate flashback; the way Esther Greenwood’s precise inner monologue steers the book into madness as effectively as the private car she laments not driving in the book’s opening pages: all of these things present the particular problem of reproducing Esther’s powerful narration with anything other than a pat voiceover. It’s a problem Gyllenhaal is uniquely suited to solve, having narrated The Bell Jar audiobook to long-running, continuous acclaim. For Plath fans in a perpetual romance with the novel, Gyllenhaal’s husky-voiced Esther Greenwood makes for a sardonic ménage à trois, highlighting the novel’s coquettish plays for the grotesque.

Plath famously spent years trying and failing to master formulaic, commercial short fiction for magazines like Ladies’ Home Journal and The Saturday Evening Post. Her fiction finally succeeded when she turned that formula on its head. In The Bell Jar, the protagonist and her cohort of women’s magazine interns attend a luncheon for Ladies’ Day, a lightly fictionalized Ladies’ Home Journal, where they are given compact mirrors engraved with their names and wreaths of white daisies, and ptomaine poisoning from bad crab salad. Plath ends the scene with eleven All-American college girls simultaneously shitting and barfing all over the shared bathrooms of their chaperoned hotel.

The barest glance at The Bride, Gyllenhaal’s latest film, shows how adept she is at handling this kind of material, binding elegance, artifice, and abjection into a caduceus of the feminine. Reviews of The Bride abound with references to its predecessors; none mention Plath, but watching the movie, her influence seemed clear as the bell jar at one point housing our leading lady’s head (Ida, played by Jessie Buckley in her usual fine form). Just before her murder, Ida’s low-life mob boyfriend forces her to eat an oyster, which she immediately throws up all over the table (perhaps a nod to Esther’s poisoned crab, one of the novel’s many symbolic deaths and resurrections). In another, she is given botched electroconvulsive shock therapy without even a muscle relaxer.

Although in The Bell Jar , this first round of ECT is a catalyst for Esther’s suicide attempt, her next round of it, done in-patient at the asylum, saves her life: The bell jar hung, suspended, a few feet above my head. I was open to the circulating air. Gyllenhaal’s Ida, murdered in the opening scenes, is brought back to life through a combination of electric shock and a mysterious solution that splatters and scars her face, as if she’s been tattooed by a Rorschach blot, branding the film, like Plath’s novel, with so many of mid-century psychiatry’s pitfalls.

It’s evident that Plath is all over The Bride; but I want the The Bride all over The Bell Jar. Gyllenhaal’s movie took heat for wanting to be too many things at once, but this is one of The Bell Jar’s central metaphors. “If wanting two mutually exclusive things at the same time is neurotic then I’m neurotic as hell,” Esther tells us, reminding us that she is both mad and driven mad by a world that pathologizes her desire. In The Bride, Gyllenhaal turns that neurosis into a bloody criminality that is also inherently Plathian—as Ida murdered her second victim, I scribbled “Now she’s not just killed one man, she’s killed two” into my notes. Plath finished The Bell Jar just prior to the famous implosion of her marriage, one that kicked her writing into the murderous ferality of Ariel, but I want that ferality transposed onto The Bell Jar . I’m reminded of Jamie Hood’s masterful introduction to Trauma Plot, where she wrote that whatever the political problems of the Women’s Marches were (and are), in 2017, she needed to be surrounded by a pack of snarling, howling women, women who took as their symbol Artemisia Gentileschi’s image of Judith beheading Holofernes.

I know that Plath is almost never associated with this kind of blood and gore, is instead enshrined in culture as a reserved death goddess (Janet Malcolm’s Silent Woman, Alvarez’s “priestess emptied out by the rites of her cult”). But there is a murderous wilderness in Plath’s life and work that we undercut because it causes such discomfort: “I have a violence in me that is hot as death-blood,” she wrote in her diary in 1958. “I can kill myself or – I know it now – even kill another. I could kill a woman, or wound a man.” This is the same ugly, messy reason some critics came for The Bride . Tongues are cut out, dead women dug up. Men rape and husbands conjure a fantasy marriage of ideals—a “matched pair,” as Diane Middlebrook wrote of Plath and Hughes—rather than one of violence and rage and deception. We don’t care for this, as a culture; we want the kind of tidy romance Hughes gave us, right down to the girlish heroine dying her tragic death, forever beautiful, a sanitized Plath which is also a sanitized Esther, dying her sad death in the crawlspace with none of its accompanying rage and comic blood and gore.

It’s evident that Plath is all over The Bride; but I want the The Bride all over The Bell Jar.

This sanitized interpretation of The Bell Jar is part and parcel of its place in today’s popular culture. You can purchase fig tree postcards on Etsy and Instagram abounds with #IamIamIam stamped upon pictures of a blond and grinning Sylvia Plath, but the truth is, the book is hideous and also funny as hell (“There’s nothing like puking with someone to make you into old friends,” Esther says of a co-worker she had previously disdained). The Rosenbergs are electrocuted—Esther imagines being burned to death along your nerve endings, “the worst thing in the world”—just prior to the young fashion magazine acolytes barfing all over each other in the back of a New York City cab. An impromptu blind date with a handsome rapist ends with Esther punching him square in the nose, his blood gushing through her fingers. When she wakes from her suicide attempt, maggots crawl in the gash she has opened below her left eye by banging her head against the concrete. Later, attempting to “unburden” herself of her virginity, she nearly bleeds out and requires stitches, an internal version of Hollywood’s Frankensteinian monsters.

Plath herself is the art monster characterized so brilliantly by Claire Dederer in Monsters: A Fan’s Dilemma. Plath shows up in Dederer’s book about (mostly) men who make great art and live monstrous lives (and what to do with them), but only as a woman who turns her violent tendencies against herself. But The Bell Jar is also fraught with the monstrousness of white supremacy and homophobia. Encountering herself in the mirror after a brutal night out, Esther sees “a big, smudgy-eyed Chinese woman staring idiotically into my face.” This moment partially inspired But The Girl, Jessica Zhan Mei Yu’s retelling of The Bell Jar, a book she characterized as being about the problem of “loving literature that hates you.” When Esther is institutionalized after her suicide attempt, she abuses a Black orderly for nothing other than the sadistic pleasure of it. Later, relocated to a posh private hospital, she tells Joan, a friend trying to confess her queerness to Esther, “You make me puke, if you want to know” (Joan hangs herself in the woods shortly thereafter).

A bad adaptation will write these scenes out of the script (a kind of Hollywood version of Puffin’s “new” editions of Roald Dahl which dispense with his racism and antisemitism). A better one would work them skillfully into the film, not as a way to judge Plath’s racism and homophobia in absentia , but to show how white feminism works, where it fails, where Plath failed, what her limits were—what ours are. Done well, this could blow that conversation up in a way that calls for the kind of reckoning Plath has been due for, for decades, now. Plath’s fans are legion and span people of every race and nationality; they deserve an answer to Zhan Mei Yu’s vital question about “loving literature that hates you.” Do it wrong—which is to say, don’t do it at all—and you fail to meet the political moment, insist on maintaining Plath’s status as dead girl beauty queen, an icon of the worst of white feminism.

This Plath—the white feminist icon—is not a Sylvia (or an Esther) that deserves, or needs, to be resurrected, is, in fact, the one time I would concur that they should never make a movie of The Bell Jar. Let white feminism die, or rather: put a stake in its fat white heart. Bringing Plath to the screen has the power to show her for what she was, what she showed us—a white woman being exploited who was nonetheless capitalizing on her racial power in a moment when women felt especially powerless. A film of The Bell Jar can show us how hideous that is, so that maybe some of us might really see it, and stop doing it ourselves. The Bride is right on the edge of this kind of political fluency—giving Gyllenhaal The Bell Jar might tip her scales. So, go ahead, Maggie. Reanimate her. I dare you.

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TV mogul Taylor Sheridan spoke about the backlash he almost baited for Landman and admitted that it didn't come as a surprise. The show was criticized by both sides of the political spectrum, a rarity for Sheridan's otherwise well-liked shows. Starring Billy Bob Thornton , Landman took longer than expected to win over the audience, but it never struggled in terms of viewership. The series has been renewed for a third season, which Sheridan is working on along with several other projects. In an appearance on The Bill Simmons Podcast , Sheridan claimed that he has never chased awards success and expressed his dislike for critics in no uncertain terms. This is odd, because the majority of his work has been warmly received. Sheridan is also an Oscar nominee, earning widespread acclaim for his Hell or High Water screenplay.

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OPINION Bosses say working from the office is all about productivity, but the truth is it's just a power trip driven by fear and narcissism. Executives who insist on people working from the office like to say it's all about productivity, culture, collaboration, and mentoring. Pull the other one; it has bells on. When executives demand that we "return to the office," they usually lean on a familiar set of talking points: remote work hurts productivity, people collaborate better in the office, and corporate culture only happens in the office. If you look closer, you'll see it's all malarkey. Recent research by Professor Adam Grant, an organizational psychologist at the Wharton School of the University of Pennsylvania, and two of his grad students found that one reason some bosses resist remote work may be a desire to preserve authority and status. Or, as the paper title so neatly puts it, "Worship me at the office altar: Why narcissistic leaders resist remote work." Over the decades, I've met and covered many top leaders, especially in tech, and I've found that all too many of them have narcissistic tendencies. Now, thanks to this study, I see this isn't just my experience. The paper is based on three studies that included Fortune 500 leaders. The researchers found: "Because in-person work offers richer channels for controlling and commanding reverence from employees, in their pursuit of authority and admiration, narcissists are likely to resist remote work." These managers argue that spontaneous hallway chats, whiteboard sessions, and faster decision cycles require colocation, especially for teams used to in‑person workflows. They insist that company culture only happens in the office and that loyalty, engagement, and shared identity are impossible to sustain remotely. They also frequently say juniors cannot be effectively trained without being in the office near seniors to absorb knowledge and norms. In my experience, leaders who teach are vanishingly rare. Companies talk a good game. The reality is something else. According to Gallup's latest American Job Quality Study, only 28 percent of workers get any mentoring. Even if you consider that a somewhat successful number, a closer look reveals that much of this mentoring consisted of a few early meetings, followed by the mentor putting off the junior employee as "real work" got in the way. Mentoring is a good idea, but without follow-through, it's a waste of time. The main reason self-absorbed bosses like to give is that remote work is less productive. For instance, Jamie Dimon, JPMorgan Chase's CEO, has long argued that remote work does not work well for people who want to "hustle" and advance. David Solomon, Goldman Sachs' CEO, famously called remote work an "aberration" that the firm would "correct as quickly as possible." You'll find this attitude in tech companies as well. Former Google CEO Eric Schmidt, for example, said in 2024 that Google was losing the AI race because "Google decided that work-life balance and going home early and working from home was more important than winning. And the reason startups work is that people work like hell. I'm sorry to be so blunt, but the fact of the matter is… you're not going to let people work from home and only come in one day a week if you want to compete against the other startups." Schmidt later rowed back on that opinion, admitting his "error" amid something of a backlash. I am so sick of that "startup" BS. Google, AWS, Microsoft, Meta, IBM, and all the rest that like to say they're rebuilding a startup work-from-the-office culture, are full of crap. Multiple billion-dollar companies are promising today's workers a shot at making millions from an IPO. They're working for a paycheck. Oh, and today, Google looks to be just fine in the AI race. Ego-driven management also relies on the old factory mentality that holds that the best workers are the ones who arrive early, work late, and are seen hustling by the bosses. Putting in 80-hour workweeks may be necessary at a startup, but in most businesses, that's as stupid as measuring programmers' productivity by lines of code or, more recently, by how many AI tokens they use. The simple truth is that, except for cherry-picked studies, such as the WFH Research's report, which found that fully remote work is associated with roughly 10 to 20 percent lower productivity, most studies find that people who work from home are happier and tend to be as productive, if not more so, than those stuck in the office. Staff forced to work from the office don't even make their employers more profitable. The bottom line is that many people love working from home – I'm one of them – and bosses who insist you must work from the office tend to be narcissistic jerks. If you have bosses like that and you're a worker bee, I encourage you to look for another, more remote-friendly employer. If you're in charge of a company and you have middle managers like that, I encourage you to look to AI to replace them. Yeah, I said it. These days, another reason such managers may want to keep people under their thumb is they know that while AI can't replace good managers, most managers can be dumped. Many of them are scared to death that someone will realize they're just messengers and meeting‑makers who contribute nothing to the company's bottom line. Worse still, from where they sit, they fear, with reason, that AI-driven services such as Jira, Asana AI, and ServiceNow can replace them in a heartbeat. I think that's a fine fate for narcissistic bosses. Fire them all and let unemployment sort them out! ®