October Was Eye Injury Prevention Month
October 31, 2013
October was Eye Injury Prevention Month. We turned for answers to Whitney Lynch, DO, a board certified ophthalmologist in private practice at 6642 E. Carondelet Drive in Tucson. Dr. Lynch is a 1995 graduate of Kirksville College of Osteopathic Medicine and did an internship and residency at Grandview Hospital. He is married and has three daughters.
Q. Nearly 45 percent of eye injuries are in the home...we assume these are mainly men, doing repairs like wood working, metal lathing and car repairs, right?
A. I've certainly have seen a high percentage of males with eye injuries from the activities you described, but the women can also sustain injuries. Some of the more common injuries include household chemical splashes (i.e. bleach or oven cleaners, etc.), but cactus thorns under the upper eye lids on a windy day in the garden also occur. We even had a lady playing with her dog on the ground and the dog nose butted her eye and caused a retinal detachment.
Q. We saw an American Academy of Ophthalmology survey that says only 35 percent of us always wear protective eyewear (that meet American National Standards Institute (ANSI) are stamped z87) while doing home repairs and maintenance.
A. Safety glasses, even those with reading glasses at the bottom, can be easily found for $5 to $15 at your local home improvement store. The frequency of eye injuries seen in our clinic goes up significantly on windy days. Your regular glasses usually will provide the best clarity and can be augmented with either safety glasses/goggles over them or a face shield over them. Anti-fog products are also available, if nowhere else, at dive shops which have them for scuba masks.
Q. If you wear eyeglasses, isn't that enough protection?
A. Polycarbonate lenses are the default "safety lens" we will use for all glasses for children and many of the adult glasses. They are a soft plastic that scratches easily and can be damaged quickly with scratching of the lenses. An inexpensive home improvement center safety lens over your glasses could save your $150-250 pair of glasses by absorbing the brunt of the dust and debris.
Q. Should you wear eye protection if you are just watching a home maintenance project, like when the kids are doing chores?A. A number of the injuries we see are caused by a co-worker next to them. This is more typical with welders or carpenters, but home improvement projects are subject to the same concerns.
Q. Won't you blink fast enough to stop most injuries? Can't tears remove most foreign bodies?
A. A reflexive blink is very quick, running 1/10th to 4/10ths of a second. If the object isn't seen before it hits, or doesn't brush against the lashes to induce a reflexive blink, the object will hit the eye first, then the lids will close over it. An object thrown from a grinding wheel could travel well beyond the speed of the reflexive blink. Regarding the tear mechanism, the phrase "we are fearfully and wonderfully made" comes to mind! Reflexively we tend to rub our eyes when we encounter a foreign body, which can imbed the item into the eye tissues, making it harder for the tears to sweep the object towards the nose, as it is beautifully designed!
Q. Most of us don't wear eye protection when cooking, doing laundry, opening champagne bottles or curling our hair. If we injure our eyes, what are the "do's" and "don'ts" of first aid?
A. Try not to rub the eyes, which once again can imbed the foreign object. Rinse the eye extensively for a chemical splash, as quickly as possible, using a gentle saline stream preferably, but regular tap water will also suffice as quickly as you can. Blunt force injuries (Champagne corks) will require a dilated eye exam to insure that the retina has not torn, or that the eye has not been cut open as soon as possible. I've only seen two curling iron burns to the eyes, both in residency and to other residents wives, most frequently when their young children were under foot. Both of the ladies did great, with no residual problems! Both sought medical attention right away and did well because of it!Q. When should we seek emergency help?
A. Things that should get your attention and cause you to seek emergency care quickly include, but are not limited to, the following: Rapid loss of vision, marked pain, 100's of new floaters, a "Black object" (like a curtain) crossing over your vision, sudden onset double vision, sudden onset of halos around lights, worst headache of your life, mechanism of an injury hard enough to cut you eye, or any number of other more subtle problems with your eyes.
Q. When should we see an ophthalmologist for an injury?
A. ER and Urgent care physicians typically do a pretty good job of getting the critical patients to us (Ophthalmologists) in a timely manner! If you are seen by an Optometrist first, you will frequently be referred to an Ophthalmologist for management and diagnosis, but not always. The nature and severity of all potential eye problems is too expansive to have a universal answer as to the timing of the visit.
Q. What are the most common eye injuries you see in your practice?
A. Metallic foreign bodies, splinters/thorns, and blunt eye trauma are the most common injuries I see.
Q. Many of us are injured playing sports. Can we get by just wearing sports goggles for all sports?
A. Sports (shatter resistant) glasses/goggles are strongly recommended by the American Academy of Pediatrics for children playing sports. With the ability to grind glasses prescriptions into Oakley or Bolle wrap around poly carbonate glasses, adults have little excuse for not doing the same for their sporting activities!
Q. Are there more dangerous sports for eyes than others?
A. Martial arts, boxing, basketball, football, volleyball tend to be the heavy offenders, but tennis, golf, badminton, etc. can also cause injuries with less regularity.
Q. Can cosmetic things like false eyelashes, lid rings and tattoos cause eye injuries?
A. The adhesives for false eye lashes can work themselves onto the eyes. Tattoo inks can cause lid inflammation for a week or two with permanent eye liners techniques. Any piercing has a potential for infection or allergic reaction to the metals (Nickel not uncommonly) in the rings.
Q. What about contact lenses, can they cause injuries?
A. One person in 200/year will have a serious problem with contact lenses. The individuals that sleep in their contacts are 7-10 times more likely to have corneal ulcers on their eyes. These are typically so painful that the patient rarely returns to sleeping in them after their ulcer treatment is completed. Even with the more oxygen permeable contacts, the eyes can't recuperate from the mechanical trauma of the lenses during the day if they are left in while they are sleeping, nor can the lenses be sterilized and cleaned. Taking a two week disposable lens and wearing them an additional 1-2 weeks produces protein and calcium deposits on the back of the contacts which can scratch the eyes. There are 4 week to 12 month disposable lens options, but we usually recommend a dedicated enzyme solution every two weeks for anything worn beyond two weeks, with thorough rinsing the next morning.
Q. Here in Tucson we get a lot of sun and we all think about sunscreen. Should we be thinking about the sun's impact on our eyes?
A. Ultraviolet light plays a role in cataract formation in addition to macular degeneration. UV irradiation also plays a role in forming pinguecula (yellow, raised areas on the whites of the eyes).
Q. Most of us take our eyes for granted, thinking they are as tough and resilient as our elbows and skin. Are eyes tough or are they fragile?
A. Eyes are very fragile and tolerate inflammation in the eye very poorly. They are populated with some of the highest concentration of nerves per millimeter in the body.
Q. Anything else you'd like to add about eye injury prevention?
A. Some of the less common injuries I see have come from: nail guns, staple guns and malfunctioning respirators that released hundreds of metallic foreign bodies into both of the patients' eyes.
Q. If patients have other questions, what are good sources of information they can use?
A. American Academy of Ophthalmology, Cleveland Clinic and Mayo Clinic should all have very reliable information on eye topics.