Help, I got something into my eye – Corneal Abrasions and foreign bodies

Photo credit:  http://www.varga.org/Physician%20Assistant%20Photos.htm

This morning a patient came into the urgent care complaining that he felt like he got something into his right eye after doing some weed whacking with a string trimmer yesterday afternoon.  He tried irrigating his eye at home with his wife’s help but it still feels very irritated so he decided to come in for evaluation.  Patient’s often wonder what to do when they get something in their eye and whether they should be seen in the clinic.

When we get something in our eye and it disrupts the surface layer, we call this a corneal abrasion.  Even if the piece of dirt, sand or other object has been removed, simply having scratched the surface layer of the eye can be painful for days and even lead to an eye infection.  We usually classify this type of injury based on whether the reason for the scratch to the surface layer of the eye is due to trauma, a foreign body such as a piece of dirt or sand, contact lens related or spontaneous.

Symptoms:  The outside layer of the eye called the cornea has lots of sensory pain fibers.  Patients typically complain of excruciating eye pain and difficulty opening the eye due to feeling like they have something in the eye.  Patients are often not comfortable enough to drive, read or work and often cannot sleep.  If patients keep trying to wash the object out, it can lead to further damage to the surface of the eye.

Complications:  If a piece of metal becomes embedded within the surface layer of the eye, it can rust and can cause a permanent rust ring within the eye than can affect vision.  It’s important to make sure any metal is removed as soon as possible.  Foreign objects within the eye can also lead to bacterial infections that can cause redness, swelling, drainage and even permanent eye damage if not treated.

Treatment:  After a thorough evaluation often with specialized equipment to look at the cornea, visual testing and specialized eye tests, the treatment will depend on what we find, but may include:

1)   Remove the foreign body – this may be done using irrigation, or with instrumentation and a slit lamp (if available)

2)   Topical antibiotic therapy to prevent or treat infection

3)   Pain relief

4)   Do not wear contact lenses for 7-10 days until after the abrasion is healed

Home treatment recommendations:

1)  If you think there is something embedded in your eye (such as a glass or metal fragment), do not try to remove it.  Go directly to your healthcare provider.

2)  If you get a chemical burn to your eye, this is a medical emergency and you should be evaluated by your healthcare provider as soon as possible.  If you’re at work, you should flush your eye with water at the nearest eyewash station.  If you are at home, you can flush your eye by holding your head under the faucet or by pouring water into your eye from a clean container.  Continue flushing for 15 to 30 minutes.  You should be evaluated by a medical professional.

3)  Never rub your eye

4)  Wash your hands

3)  Look in the mirror and try to find the object in your eye

5)  If the object is under the upper eyelid, grasp the lashes of your upper eyelid and pull it down while looking upwards.  After your’ve done this and if you see the object is out from under the top eyelid, flush the eye with saline

6)  If the object is under the lower eyelid, remove it with a clean wet cotton swab or the corner of a clean cloth while holding the lower lid open.

7)  Flush the eye with lukewarm water

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

 

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

I have a Stye in my Eye – Eyelid Pain

shutterstock_147818714A style (also called a hordeolum) is a red and painful lump on the eyelid.  This occurs when a small gland in the edge of the eyelid become infected or inflamed.  Styes can occur on the upper or the lower eyelid and usually get better on their own after a few days to week even if untreated.

Symptoms:  Red or painful lump on the edge of the eyelid.  It often looks like a pimple, and can cause tearing as well as eyelid pain.

When to see a healthcare provider:

1)   It doesn’t go away after 1 week.

2)   It gets large, bleeds or affects your vision

3)   The entire eye or eyelid becomes red/swollen

4)   The redness or swelling spread to your cheek or face

Home treatments:

1)   Wet a clean wash cloth with warm water and put it over your stye for 10-15 minutes 3-4x/day

2)   DO NOT squeeze or pop the stye

3)   Avoid wearing eye backup or contact lenses

Prevention:

1)   Wash your hands before touching your eyes or eyelids

2)   Wash your hands before putting in contact lenses and keep the lenses them clean

3)   Take off eye makeup at night if you use it

4)   Do not use old eye makeup or share with others

Medical provider treatments:  Most of the time we prescribe antibiotic ointments or drops if the stye is not improving on its own.  If it persists or gets larger, a referral to an eye doctor is usually made who can drain the stye.

The American Academy of Ophthalmology has a great resource for locating an ophthalmologist near you: http://www.aao.org/find_eyemd.cfm

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

 

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

Pink Eye, Oh My! What to do about your red eyes

shutterstock_126608381Pink eye is also known as conjunctivitis which literally means “inflammation of the conjunctivia.”  The conjunctiva is the thin membrane that lines the inside surface of the lids and the white portion of your eye.   It is one of the most common conditions seen in the medical office in kids and adults, especially because it can be contagious and parents bring their children in to the doctor because they cannot attend daycare.  Kids are often sent home from school with this condition due to worry about spreading it around the classroom.

Conjunctivitis is usually not serious, and often goes away on it’s own even if no treatment is given.  More serious conditions that can cause pink eyes are acute angle closure glaucoma, iritis, and infectious keratitis.

It is important to be examined by a healthcare provider since there are many conditions that can cause eye redness and discharge.  Common questions that your healthcare provider may ask are:  When it began?  Has anyone else in the house had similar symptoms?  Is there continuous discharge from the affected eye?  Is the discharge watery, thin and mucus-like or thick and sticky?  Are there non-eye symptoms such as cough, fever, sore throat, runny nose,  or sneezing?

There are 4 main types of conjunctivitis:

1)   Viral infectious

2)   Bacterial infectious

3)   Allergic non-infectious

4)   Nonspecific

Viral conjunctivitis:  Can be caused by a common cold.  You may have symptoms of an eye infection alone, or as part of a general cold syndrome with swollen lymph nodes (glands), fever, sore throat and runny nose.  It is very contagious, and usually spread by contact with objects that have come into contact with the infected person’s secretions.  An example is when the infected person touches their eye, and then touches another surface such as a door handle or shares an object that has touched their eye (pillow case for example).

Symptoms of viral conjunctivitis are redness, gritty feeling in one or both eyes, mucus or watery discharge.  There might be crusting in the morning followed by watery discharge.  The second eye then might also become infected within a couple days.

Treatment of viral eye infections:  There is not a medicine that will cure a viral conjunctivitis.  You usually will start feeling better within a few days although symptoms can get worse for the first 3-5 days.  Gradual improvement usually occurs over 1-2 weeks.  Morning crusting can continue for up to 2 weeks after initial symptoms although redness, irritation and tearing should be improved.  A topical antihistamine eye drop may help relieve the itching and irritation of the viral eye infection.  These drops do not require a prescription.  A common eye drop used is called Visine (don’t use the one that says it has a decongestant or says “gets the red out.”  Another antihistamine medicine that is often helpful is called Zaditor.  Make sure you wash your hands to prevent spread of the infection.  A warm or cool compress over the eye may also help reduce the discomfort.

Bacterial conjunctivitis:  It can be very difficult to distinguish between a bacterial and viral eye infection.  A bacterial eye infection is very contagious and often affects multiple family members.  It is spread by contact similarly to viral eye infections.  The symptoms may be redness, and thick discharge from the affected eye.  Both eyes, however may become infected.  Discharge may be yellow, white or green and it usually continues through the day.  The affected eye is often stuck shut in the morning.

Treatment of Bacterial conjunctivitis:  Usually we treat with an antibiotic eye drop or ointment.  The ointments stay in the eye longer and therefore usually don’t have to be applied as often.  Erythromycin ophthalmic ointment is an example, and is applied inside the lower eye-lid about 3-6 times per day for 10 days. The ointment tends to blur the vision while it’s there because it’s an ointment, so many patients prefer the drops instead.  The antibiotic eye drops and applied more often (up to every 2 hours) because they are washed away easier by tears.  Sometimes eye redness can get worse after using antibiotics if the patient is allergic to the drop.  This is common with gentamycin antibiotic eye drops.  If that occurs, switching to a different antibiotic can be helpful.    The redness, irritation and discharge to should improve within 24-48 hours.

Non-Specific conjunctivitis:  Sometimes inflammation of the conjunctiva of the eye occurs without infection or allergy.  There are several causes for this:  Dry eyes, inflammation due to contact with a chemical/irritant, or a foreign body in the eye (such as dust, or an eyelash).  The redness and discharge can continue for 12-24 hours after the object is removed.

Allergic conjunctivitis:  Eye symptoms/redness caused by allergies usually is accompanied by itching, and possibly a runny nose, itchy throat and sneezing.  Some or all of these accompanying symptoms due not have to be present.

If you wear contact lenses:  You should be examined by a health-care provider before starting treatment.  Sometimes an infection to the cornea can occur when wearing contacts and that is more serious.  While you have conjunctivitis, it is generally recommended not to wear your contact lenses.

When to see an eye care specialist:  Usually your doctor will refer you to an eye specialist if you have any of the following symptoms which may indicate a more serious problem:  Pain with eye movement, trouble seeing, difficulty keeping the eye open or sensitivity to light, severe headaches with nausea, recent eye trauma, use of contact lenses.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

 

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com