Foreign Bodies in the Eye
It is the season. The season for working in the yard, cutting grass, whacking the weeds, blowing sidewalks clear, power-blasting your driveway and crawling under that '57 Chevy to change the oil. It is the season for FOREIGN BODIES to collect in your eyes!
I have seen my share of ocular foreign bodies and most of them are preventable. Probably the most common FB (foreign body) seen in Kingwood is a small piece of brown, shell-like material that must come from all of our trees. It is smooth and rounded on one side but rather sharp on the other. It is this sharp side that attaches itself to the eye! I have found these pieces on the cornea (the clear front part of the eye), the conjunctiva (the clear membrane on the white part of the eye) and most commonly on the palpebral conjunctiva (the underside of the upper eyelid). This type of FB will almost always stay attached to the eye until your eye doctor removes it. It will dislodge quite easily with a "spud" or other sharp instrument that your doctor may use. Your eyedoc will first numb the eye with anesthetic eye drops, then gently lift the FB from where it sits while looking through a slit lamp, or specialized microscope. He may then apply an antibiotic ointment to prevent infection. Sometimes a patch is used for the first 24 hours. This patch may be a conventional, sterile eye patch or might even be a soft disposable contact lens!
The advantage of a bandage contact lens is that the patient can still "use" the eye with the "patch" on. It is also possible to use antibiotic eyedrops for short periods (24-72 hours) while the disposable contact is in place. The type of patch used is usually dependent on the form and extent of the abrasion and the patient's willingness to wear a contact lens for up to three days. Most simple foreign bodies will NOT require any type of patch since the abrasion on the eye is minimal. The scratch on your cornea from your child's fingernail……well, that's another story!
Another rather common foreign body found in the eye is metal. Just working under that old Chevy will release a large amount of small metal pieces that are typically flat but rough…perfect for adhering to the ocular surface. An additional danger of metal in the eye is the tendency for these lesions to produce a rust ring that may remain after the metal piece is gone! The rust ring then becomes a second foreign body that is more difficult to remove than the original metal. If you ever suspect a piece of metal in the eye (working on your car, hammering nails, working on a grinder or in a metal shop) call your eyedoc within 12 hours or less to avoid the formation of rust.
One rather interesting case involved a local dentist who, while working on a patient, felt something hit his eye and later presented in my office with a foreign body sensation. Under slit lamp observation I could see a very minute piece of tooth embedded in the center of the cornea! (And you know who you are, Woodman!) Despite his wearing protective glasses, this particular tooth particle found its way to the center of the eye. The tooth fragment was removed without complication.
It would be prudent to consider the purchase of safety goggles (most will fit over your regular glasses) if your activities place you in the vicinity of high speed debris. You cannot be too careful when you're protecting your most precious sense.