Edgar Allan Poe's short story The Tell-Tale Heart is about a man of indeterminate age who is driven insane -- but was clearly already mentally ill to some degree -- by the sight of one of the eyes of the old man with whom he shared a home. That eye, described by Poe's narrator as resembling "that of a vulture—a pale blue eye, with a film over it," is terrifying, and a constant source of anxiety. The mere sight of the old man's deformed eye sends chills down the narrator's spine or, as he states in the story, makes his blood run cold. The narrator takes pains to emphasize that he otherwise harbored no ill-will towards the old man, but that the eye was sufficient in-and-of-itself to warrant the elderly roommate's murder.
Now, let's examine the opening passage of Poe's story, which reads as follows:
"TRUE!—nervous—very, very dreadfully nervous I had been and am; but why will you say that I am mad? The disease had sharpened my senses—not destroyed—not dulled them. Above all was the sense of hearing acute. I heard all things in the heaven and in the earth. I heard many things in hell. How, then, am I mad?"
With this opening, Poe has established a disquieting tone. We don't yet know, of course, what will transpire, but we know that the narrator is, protestations aside, insane. And, he is not just insane, but criminally insane, as his continued narration confirms. Poe, of course, was a master of the macabre. His stories and poems are studied today because of his skills as an author, because of the unconventional themes he employed, and because of his death at a tragically early age (he was 40-years-old when he died). Poe's continued narrative describes a somewhat claustrophobic existence, with the two roommates inhabiting their own secluded little world. Because he provides the details of the old man's eye early in the story, and because he has his narrator conclude this brief description of the old man's eye with his declaration of intent to murder the old man ("—I made up my mind to take the life of the old man, and thus rid myself of the eye for ever"), the atmosphere of fear and dread the author has created sustains the narrative throughout its duration. Adding to this sense of horror is the narrator's night-time practice, in preparation for his evil deed, of peering into the old man's bedroom to gaze upon his intended victim at rest. Bad things happen in the dark, and the old man's terror when awoken in the darkness of night pretty much follows along the path established in the above opening passage.
The Tell-Tale Heart is, obviously, a very short story, a mere six pages in length. Mood had to be established quickly, and those opening paragraphs accomplish that mission very well. Any effort at paraphrasing Poe's story, then, should begin with the characterization provided in the obviously insane narrator's protestations that he is anything but.