(c) Visible foreign body. Sometimes you can look at the cornea of the
patient's eye and see that there is something on the cornea. If the patient complains of
feeling something on the eye, but you see nothing try looking at his eye through a
magnifying glass.
(4) Treatment. Topical anesthetic (tetracaine 0.5%, 2 drops) is given only
for foreign body object removals. NEVER give the patient anesthetic drops to use. One
method of removing the foreign object is to irrigate the eye with normal saline in an
attempt to wash out the foreign body. Removal may be attempted with a wet swab.
NEVER dab with a dry cotton tip because the cotton tip leaves fuzz in the eye. To
control infection after the removal of the foreign object, Polysporin (polymyxin B--
bacitracin) or gentamicin drops or ointment may be used. Patch the injured eye for
comfort, and examine the eye daily for evidence of infection.
CAUTION:
Any object or medication placed in the eye must be sterile and made for
ophthalmic use only. Healing should occur within 24 or 25 hours.
e. Abrasions (Corneal). A corneal abrasion is a scratch on the surface of the
cornea. This type of scratch can be caused by a foreign body--cinder, piece of dust,
dirt, grit--that becomes embedded under the eyelid. The cornea may still be scratched
even if tears wash out the foreign body. Other causes of corneal abrasion include
scratch by a fingernail or piece of paper. Symptoms of corneal abrasion are the same
as for superficial foreign body: increased tearing, redness, etc. Treatment includes
topical application of antibiotics such as polmyxin B or gentamicin. Patch the injured
eye for a period of 12 to 24 hours. Check the eye each day to see how the abrasion is
healing.
f. Burns. Heat, light, or chemicals can cause burns to the eyes. Burns caused
by ultraviolet radiation such as sunlamps or sunlight or burns caused by electrical flash
are usually self-limiting. A chemical burn, however, is a medical emergency.
(1) Eyelids. Sometimes only the eyelids are burned. Don't try to inspect the
eyes to see if they are damaged. Instead, have the patient close his eyelids and cover
his eyes with sterile, moist fluff dressings.
(2) Eyes--extremes of light burns. It is possible to suffer burns to the eyes
from extended periods of exposure to the brightness of sun reflected from sand or snow
or from the flash of an arc welder. Gradually, the patient experiences eye pain and has
the sensation that sand has blown in his eyes. Treatment includes placing moist
patches over the patient's eyes and keeping at rest in the supine position with his upper
torso elevated fifteen to thirty degrees. Meperidine (Demerol), a narcotic analgesic,
can be given as required for pain.
MD0582
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