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Saturday, 18 February 2012

Recurrent Corneal Abrasion

Recurrent Corneal Abrasion
Corneal abrasion
(green when seen with fluorescein drops added)

Recurrent corneal abrasion is a painful eye condition, although your eye heals after a few hours or days. It is caused by a scratch on the surface of the eye in the previous months. Although the first injury heals, the healing is not perfect and the 'scratch' returns over the next months for no apparent reason. This page describes what is happening, and how you can reduce the number of recurrences.

Typically the condition starts when the surface of the eye is scratched, possibly by a finger nail. A patch of epithelium is scratched off or wrinkles up, leaving a bare patch of cornea.As the cornea has many nerves, this injury feels exquisitely painful, like a needle.The abrasion always heals and the pain goes.The healing takes 1mm a day from each side, so a large 7mm abrasion takes about 31/2 days, less in children, longer if you are older.
When a doctor looks into your eye, even with the microscope slit lamp in the Eye Department, it may be very difficult to see the injury.Sometimes it may not be apparent at the first examination. The doctor or nurse uses a yellow dye, called fluorescein, to examine your eye, and this dye sticks to a bare patch of cornea if there is one.There may not actually be a bare patch the cornea may just be wrinkled and very loosely attached.
Normally the epithelium sticks down to the layer underneath (the basement membrane) firmly. Tiny pegs underneath the cells that make up the epithelium keep the cells stuck on to the basement membrane.This is like painting on a wall: if you paint on the undercoat first, and then paint on the top coat, when the paint dries it will be well stuck down.However, these pegs may take 6-12 months to reform properly after the original injury. During this time the epithelium may be prone to slipping and sliding, and this slipping and sliding causes this condition.This is like painting on a bare surface with a 'top coat' of paint, when there is no 'undercoat'. The paint will dry but peel off really easily.A few people will this condition have inherited genes that make this sticking process faulty, but this is quite unusual.Certainly if your condition keeps happening year after a year a corneal specialist may detect this condition.

A second reason for the faulty sticking may lie in your tears.The glands in your eyelid, especially your lower lid, make secretions that help tears to spread. If these glands get blocked, your tears do not spread properly, and the eyelid may stick to the epithelium and pull it off before the pegs have firmly fixed it in position.If you clean your lids as below, the glands start to make their secretions again, and the process stops.In addition to the regular cleaning of the eyelids, sometimes using a cream at night can stop the sticking (the 'sticking' of the eyelid to the epithelium occurs when you wake up in the morning).

Source:
www.goodhope.org.uk

Corneal Abrasion Contact Lenses



Many people are able to wear lenses continuously for many days with no apparent problem or complication. However, sleeping in contact lenses, while convenient, substantially increases the risk for infection and other complications. The oxygen supply to the cornea drops overnight while wearing a contact lens. This can lead to swelling of the cornea (giving blurred vision or the visualization of rainbows around lights), breakdown of the corneal surface, and ultimately infection of the cornea (ulcer). This risk is high enough that many eyecare providers discourage against the use of contact lenses on an extended wear basis. If the lenses are used this way, extreme caution should be taken, and the lenses should be removed with any sign of trouble (eye redness, pain, blurred vision, sensitivity to light, etc.) In fact, it may be reasonable to consider refractive surgery as an alternative to extended wear contact lens use.

For more information about contact lens complications please visit www.perret-optic.ch

Friday, 17 February 2012

Prevent Corneal Abrasion

Most corneal abrasions can be prevented, especially those that happen in the workplace or during sports. To help prevent corneal abrasions and other types of eye trauma, you can take these actions:
  • Do not rub your eyes.
  • Carefully trim your infant's fingernails.
  • Use appropriate protective eyewear at work. Studies have shown that goggles and other protective eyewear can reduce the risk of work-related eye injuries by more than 90%. For more information, contact the U.S. Department of Labor's Occupational Safety and Health Administration.
  • If you are an athlete, ask an experienced ophthalmologist, optometrist or optician for help in selecting protective eyewear that is appropriate for your sport. For example, sports goggles with polycarbonate lenses may be recommended for athletes who play handball, soccer, badminton or basketball.
  • Have your protective eyewear fitted by a professional. A proper fit will help to prevent dust and flying debris from going around or under your eyewear.
  • Clean your contact lenses thoroughly before you insert them, as directed by your eye care professional. Also, make sure that your hands are clean whenever you handle your lenses.
  • Don't sleep in your contact lenses.
Tip : If you do have eye pain or a foreign object, consider seeing an eye specialist immediately rather than going to the emergency room as many emergency rooms will need to refer you to an eye specialist anyway. However, if you have a severe injury or chemical splash, call 911 or go immediately to the nearest emergency room.

Corneal Abrasion Picture

Corneal Abrasion Picture
Corneal Abrasion Picture
Image source: wikipedia


Corneal Abrasion Picture
Corneal Abrasion Pictures

Corneal Abrasion Picture



Fluorescein staining, showing abrasions on the cornea
of the eye.





Corneal abrasion is a medical condition involving the loss of the surface epithelial layer of the eye's cornea. A corneal abrasion occurs when there is a loss of cells from the epithelium or surface of the cornea. It is usually due to trauma but may occur without trauma such as with the overuse of contact lenses.

Thursday, 16 February 2012

Corneal Abrasion Symptoms

A corneal abrasion is a worn or scraped-off area of the outer, clear layer of the eye (cornea).
A corneal abrasion is usually the result of direct injury to the eye, often from a fingernail scratch, makeup brushes, contact lenses, foreign body, or even twigs. Patients often complain of feeling a foreign body in their eye, and they may have pain, sensitivity to light, or tearing.

Some corneal abration symptoms that can be experienced are:
  • A feeling that there is something in the eye – this feeling often starts a few hours after any injury instead of immediately.
  • Eyes watery
  • Distortion or blurred vision
  • When exposed to any bright light – severe eye pain
  • Muscle spasms surrounding the eye – causing individual to squint
An individual should see an ophthalmologist/eye specialist, if any of the following are experienced:
  • Eye pain – with or without any associated injury to the eye
  • Sudden loss of vision or a sudden substantial blurring of vision
  • Eye injury from high-speed equipment, such as a grinding wheel, hammering upon metal or from carpentry sanding – any of these can cause a tiny fragment to get in the eye
  • Have a sensation that something is in your eye
  • Exposure to sunlight or indoor bright lights cause eye pain which is severe
  • Redness of the eye
  • Experience of minor eye symptoms in the presence of an eye condition which is known or in the presence of having sight in only one eye
  • Pain lasts more than a few hours or is very severe.
  • Wearing of contact lens longer than normal
  • Chemical or heat burn to the eye
  • Returning pain of an eye injury that had seemed to have resolved with treatment
Go to the hospital’s emergency room if experiencing any of the above as well as unable to be seen by an ophthalmologist.

Corneal Abrasion Blurred Vision

Contact lenses are better at correcting certain types of vision problems than others. Simple nearsightedness or farsightedness is usually easily corrected using contact lenses, but astigmatism can be more challenging to correct, especially with soft lenses. Contact lenses have varying success in correcting the need for reading glasses, with bifocal contact lenses being successful in only about 50% of people.

Toric soft lenses have an astigmatism correction built into the lens, but rotation of the lens can lead to a shifting of the astigmatism correction, and temporarily blurred vision. For people with severe or irregular astigmatism, gas-permeable lenses or hard lenses may offer better visual results. Irregular astigmatism is a situation where the cornea is distorted due to a scar or underlying disorder. Sometimes rigid contact lenses are the ONLY way to correct the vision in these cases, as even glasses will not help (as in keratoconus).

Many people who use contact lenses may experience halos around lights at night, and sometimes ghost images. This probably is a normal phenomenon in most people, and occurs when the pupil is larger (or more dilated) than the optical area of a soft lens, or of the lens itself in cases of rigid lenses. However, seeing a rainbow around lights indicates swelling of the cornea (corneal edema), and indicates that the lenses have been in too long and should be removed.

Blurred vision in one eye or the other with a contact lens that was previously clear could indicate a more serious eye problem, and should be checked by the lens prescriber. Of course, it is possible that lenses can become switched between the eyes, but usually this is fairly obvious. An older lens can develop deposits and other surface problems which can make the vision not only blurry, but also can make the lens uncomfortable to wear.
For more information about blurred vision problems please visit www.perret-optic.ch

Tuesday, 14 February 2012

Corneal Abrasion ICD 9

The ICD 9 code for Corneal Abrasion is 918.1.

For more iformation about ICD 9 code please visit some of the related sites.

http://www.optometricmanagement.com/articleviewer.aspx?articleid=71724

http://en.wikipedia.org/wiki/Corneal_abrasions

http://www.icd9data.com/2011/Volume1/800-999/910-919/918/918.1.htm

Corneal Abrasion Treatment

The cornea has a remarkable ability to heal itself, so treatment is designed to minimize complications. If the abrasion is very small, the doctor might just suggest an eye lubricant and a follow-up visit the next day. A very small abrasion should heal in one to two days; others

usually in one week. However, to avoid a possible infection, an antibiotic eye drop may be prescribed. Sometimes additional eye drops may make the eye feel more comfortable. Depending upon the extent of the abrasion, some doctors may patch the affected eye. It is very important to go for the follow-up checkup to make sure an infection does not occur. Use of contact lenses should not be resumed without the doctor's approval.

Related article : Corneal Abrasion Home Treatment

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