Eye Infections and Injuries
Jacob Gerlitz, NP
There are many different complaints surrounding eye pain that are treated in our clinic. The most common is people complaining of “red eyes,” which is a classic sign of ocular inflammation. The causes range from simple conjunctivitis (pink eye) to corneal abrasion, corneal ulcer, and glaucoma. The treatment and prognosis of a red eye depends on its cause. Most cases are benign and can be treated in an urgent care center. Some conditions require antibiotics, removal of foreign bodies, and some emergency stabilization with prompt ophthalmological consultation.
Conjunctivitis is very contagious. It is passed onto others by direct hand contact after infected eyes are rubbed. Washing hands is key to preventing it from spreading. Signs and symptoms of eye infections are redness, swelling, and discharge of the eye. Conjunctivitis discharge persists all day; it’s not just crust in the eyes upon waking. If there is light sensitivity and painful vision, it could indicate corneal involvement such as a corneal abrasion.
Infections and inflammations of the eyelids is called blepharitis. Commonly, there is eye irritation, itching, erythema of the eyelids. It’s usually a chronic condition with acute exacerbations, and associated with other skin disorders such as eczema. Normally, the treatment of blepharitis is eyelid hygiene with special cleaning techniques. But the eyelid inflammation can be due to Herpes simplex or varicella-zoster viruses which can progress to corneal involvement. The eyelid infection can also be due to staph infections which need antibiotics.
Foreign Body in Eye
Foreign bodies in the eye can be due to all sorts of flying debris. Foreign bodies lodged in the eye need to be examined and removed. To remove a foreign body, flush the eye with water. Do not rub the eye. If it’s painful, or if there is light sensitivity, it might indicate a corneal abrasion. Simple foreign bodies can be managed in an urgent care center, where there are special lights that can visualize the eye.
Never rub the eye if a foreign body is suspected because it can lead to abrasions or corneal ulcers. If there is an abrasion, antibiotic ointment will be prescribed. Corneal ulcers are an emergency. Risk factors for corneal ulcers include contact lens use, trauma, chronic eye conditions, and prior eye surgery. Overnight contact lens wear is associated with increased risk, as is inadequate contact lens hygiene.
Causes of serious eye injuries:
Eye injuries may occur after blunt injury during motor vehicle accidents from air bags and seatbelts. Projectile injuries in men are the most frequent causes of eye injuries with a common cause being home improvement projects. Always wear eye protection when there is a risk of flying debris. One third of eye injuries occurring in children and adolescents (< 16 y) are sports related, with basketball, baseball, racquet sports, and martial arts being mostly implicated. Pellet guns, BBs and paintball pose a significant risk. These types of injuries are ophthalmological emergencies.
All acute vision changes such as diminished vision, vision screen, loss of peripheral vision, halos, spots in vision, or flashing lights must be evaluated promptly.
It is thought to be the fluid of the eyeball clumping which leads to black dots, or little strings in the visual field that seem to follow your gaze. Floaters are chronic, however they seldom cause problems. Orthostatic hypotension (the drop in blood pressure caused by going from a sitting to a standing position) can cause spots in the vision that are transitory. But, acute, spontaneous flashing lights in one’s visual field can be due to retinal detachment and are an ophthalmological emergency. Vision disturbance or loss of vision, especially associated with acute pain or trauma is an emergency and must be evaluated and treated by an ophthalmologist or an emergency department that has ophthalmology services.
In general, special consideration is given to people who wear contact lenses, even if they are not wearing contact lenses at the time of an acute eye complaint. This is because wearing contact lenses predispose a person to more severe infections and complications. Conjunctivitis in a person who wears contact lenses is treated differently and more aggressively than a person who doesn’t wear contacts.
It’s important you get a correct diagnosis in a timely fashion. Some causes of red eye require ophthalmologic consultation within an appropriate time period. Corneal ulcers, deep eye infections, penetrating foreign bodies, and other conditions must be seen promptly. Uncomplicated cases of eyelid swelling, conjunctivitis, and foreign bodies may be managed in an urgent care clinic or via a house call.