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Saturday, 25 February 2012

Corneal Abrasion Surgery

Lasik Procedure with Corneal Abrasion Complication

After thinking about getting Lasik eye surgery for over 10 years I finally got it done recently. The last time (about 10 years ago) when I seriously considered getting it done a friend referred me to a website with horror stories about Lasik surgeries gone bad. The same friend eventually got the procedure and was very happy with the results.

Over the years everyone I met who had Lasik eye surgery would rave about how much they were happy with the outcome and that it was one of the best decisions they made in their life. So as the years passed I finally decided to bite the bullet and do it. I was growing really tired of wearing glasses and didn’t want to wear contact lenses because when I first tried them I didn’t like the way they felt in my eyes. Also, I have really bad allergies, especially around allergy season, and I knew contacts would be a problem then.

I initially made an appointment for a consultation and was informed that since I am over 40 years old there is a chance I may need reading glasses soon after the surgery. It was explained that people over 40 would start to need reading glasses and it is just a natural decay in your eyes that Lasik cannot fix or prevent. This was indeed a concern because I didn’t want to get Lasik and then have to wear reading glasses soon after. The problem is no one knows at what age you need reading glasses. Some people are fortunate enough to not need reading glasses until their 50s. Regardless after careful consideration I decided to have the procedure done anyway.

I ended up going with LasikPlus because the doctor came highly recommended by 2 friends who had the procedure done by the same doctor who would do my surgery. I also like the fact that the doctor has performed over 65,000 procedures and used the latest LASIK equipment. I also didn’t find much negative reviews of the doctor on the Internet. Actually, I found mostly positive reviews about his performance.

As with any medical procedure or even taking prescription or over-the-counter drugs, there are risks involved. After my consultation I was given some paperwork that described potential risks of the surgery which was scary. One of the risks listed could result in death. How scary is that?

In doing some research, I discovered about 2% of individuals having the surgery have some type of complication so I was praying that I’d fall into the 98% who have no complications. I was told I was a good candidate for the surgery and that everything should go well.

The Surgery

The surgery was fast and painless. The only discomfort was pressure on my eyes for a few seconds to make the flap. The laser to reshape each cornea took about 5 seconds each. Your eyes are numbed with eye drops so there is no pain at all. After the surgery my eyes felt a little sore and sensitive to light. While being driven home my vision was much improved but with a haze. I kept my eyes closed and just wanted to go home and take a nap, however, I couldn’t sleep because my eyes were burning. It was a slight burn but enough to make me uncomfortable. After a few hours, my right eye was extremely tearful. As soon as I open my eye water poured out. My left eye wasn’t as tearful.

My follow-up exam the next day revealed that I had a cornea abrasion on my right eye. “Just great”, I thought to my self. I wasn’t happy hearing that I had a complication.

My Complication

During the LASIK procedure I developed a small corneal abrasion in my right eye. As stated, during the first night, both eyes burned a bit, but my right eye was extremely tearful. The next morning it felt uncomfortable to open both eyes, but especially my right eye. I had a follow-up appointment that morning with an assistant doctor who told me of the corneal abrasion. I was then sent to another location where the Lasik surgeon was working that day. I was really irritated that I had this problem. I kept thinking to myself, “just my luck”.

From some research about corneal abrasion, even with excellent surgical technique and a moistened eye, a small breakdown in the epithelial surface may develop as the flap is made with the microkeratome. Corneal abrasion occurs in a small percentage of LASIK procedures because in some eyes the surface cells may not adhere well. There is no way possible to detect who may be prone to corneal abrasion. Fortunately, the epithelium grows back so quickly that eyes with an epithelial defect usually heal within a few days, even without a contact lens.

My surgeon verified that there was indeed an abrasion and that he’d place a contact lens on my eye to help it heal and make it more comfortable. As soon as he placed the contact lens in my right eye, it felt 100% better. I could immediately open my eye and there was no discomfort. My eye stopped tearing. He also numbed the eye, so that helped. As the numbness wore off my eye still felt comfortable. The contact lens was removed 3 days later and my eye still felt comfortable because the abrasion had healed.

Unfortunately, due the corneal abrasion my right eye was slightly blurred for a few days. I was told to place the prednisone anti-inflammatory drops in my eyes more frequently because my eye was inflamed at the location of the corneal abrasion. My left eye was perfect, but with my right eye was slightly blurry which was a little annoying especially when watching TV.

2 Weeks Later

Now after about 2 weeks my right eye is still slightly blurry. My left eye is 20/20 and right eye is 20/50, however with both eyes my vision is 20/20. Seems my brain has adapted for the difference. With both eyes open outside, my vision is crystal clear and I can’t see a difference but when I close each eye to compare I can see a difference. However, when I’m indoors, especially at night I can sense a difference with both eyes open. It seems indoor artificial light affects me more.

At my last check up, my surgeon stated the inflammation/swelling is gone and now the abrasion just needs to come together and that light would affect the eye making things blurry until it healed. There is an 85% chance it will heal by itself. However, if it doesn’t completely heal, he’ll do an enhancement to make the eye 20/20. I’m hoping my eye will completely heal by itself, however, if I need an enhancement I’ll have to do it. An enhancement if needed will not be done for another 3 months.

Conclusion

So far, I’m “almost” happy with the results. I say “almost”, because of the complication with my corneal abrasion. But even with 20/50 in one eye, my vision is almost perfect. Over the last 2 weeks, on numerous occasions I’ve attempted to take my glasses off and have to remind myself, that I’m not wearing glasses! The procedure was painless and fast. Recovery was also fast. If and when my right eye is 20/20, then I’ll be completely happy with the results.

Update on 9/11/2011:
About 3 months after my Lasik surgery my eye-sight is excellent at 20/20. My right eye with the corneal abrasion has healed nicely. My left eye which became a little blurry 2 weeks after the procedure has cleared up nicely as well. The glare / halos / starburst at night / low light have decreased dramatically to almost to being unnoticeable. I suspect over the next several months, it should be completely gone. So now I’m very happy with my decision to have Lasik. At times I’m amazed at how excellent my eye-sight is and how men created a device that uses a laser to reshape people’s cornea to fix their vision. Absolutely amazing! Just hope my eye-sight stays like this for years to come.

Source: http://money-cake.com

Related article about corneal abrasion surgery:
http://cataract-surgery-information.blogspot.com

Recurrent Corneal Abrasion Syndrome

Recurrent Corneal Abrasion Syndrome:
At times, the healed epithelium may attach poorly to the underlying basement membrane. In such cases, it may come off at intervals and give rise to recurrent corneal abrasions. Recurrent corneal abrasions are characterized by sudden relapse of ocular pain, sensitivity to bright lights, foreign body sensation and tear discharge.

A laser operative procedure, known as Phototherapeutic Keratectomy, is often used for recurrent Corneal Abrasion treatment.

Friday, 24 February 2012

Corneal Abrasion Test


Fluorescent eye test
Image source: www.nlm.nih.gov


Fluorescein eye stain
This is a test that uses orange dye (fluorescein) and a blue light to detect foreign bodies in the eye. This test can also detect damage to the cornea, the outer surface of the eye.

How the Test is Performed
A piece of blotting paper containing the dye will be touched to the surface of your eye. You will be asked to blink. Blinking spreads the dye around and coats the "tear film" covering the surface of the cornea. (The tear film contains water, oil, and mucus to protect and lubricate the eye.)

A blue light is then directed at your eye. Any problems on the surface of the cornea will be stained by the dye and appear green under the blue light.

The health care provider can determine the location and likely cause of the cornea problem depending on the size, location, and shape of the staining.

How to Prepare for the Test
You will need to remove your contact lenses before the test.

How the Test Will Feel
If eyes are extremely dry, the blotting paper may be slightly scratchy. The dye may cause a mild and brief stinging sensation.

Why the Test is Performed
This test is useful in identifying superficial scratches or other problems with the surface of the cornea. It can also help reveal foreign bodies on the eye surface. It can be used after contacts are prescribed to determine if there is irritation of the surface of the cornea.

Normal Results
If the test result is normal, the dye remains in the tear film on the surface of the eye and does not adhere to the eye itself.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean
  • Abnormal tear production (dry eye)
  • Corneal abrasion (a scratch on the surface of the cornea)
  • Foreign bodies, such as eyelashes or dust (see eye - foreign object in)
  • Infection
  • Injury or trauma
  • Severe dry eye associated with arthritis (keratoconjunctivitis sicca)

Risks
If the fluorescein touches the skin surface, there may be a slight, brief, discoloration.

Considerations
This test is very useful for detecting injuries or abnormalities on the surface of the cornea.

References
  • Knoop KJ, Dennis WR, Hedges JR. Ophthalmologic procedures. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2004: chap 64.
  • Hurwitz JJ. The lacrimal drainage system. In: Yanoff M, Duker JS, Augsburger JJ, Azar DT, eds. Ophthalmology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 98.

Corneal Abrasion Diagnosis

The cornea is the transparent, dome-shaped "window" that covers the front of the eye. A nick, scratch or scrape of the cornea is called a corneal abrasion. Corneal abrasions are one of the most common forms of eye injury. In some cases, they are caused by the direct impact of a sharp object, such as a pencil, staple, nail or sewing pin. They also can be caused by small, airborne particles, such as dust, sand or flying debris from soldering, woodworking or weed trimming. Even fingernails can cause a corneal abrasion.
  • A history of eye trauma or prolonged wearing of contact lenses as well as typical symptoms suggest corneal abrasion. Staining the cornea with fluorescein stain confirms the diagnosis: The injured area appears green when examined with a Wood’s lamp or black light. Slit-lamp examination discloses the depth of the abrasion.
  • Examining the eye with a flashlight may reveal a foreign body on the cornea; the eyelid must be everted to check for a foreign body embedded under the lid.
  • Before beginning treatment, a test to determine visual acuity provides a medical baseline and a legal safeguard.
Your doctor will examine your eye with a light to check for any obvious corneal injuries, small specks of dust or dirt, or other foreign objects. To confirm the diagnosis of a very small corneal abrasion, your doctor may need to place a small drop of a yellow-orange dye called fluorescein into your eye. This dye will cause any area of abrasion to look greenish under a special blue light.

Usually, if you have only a mild corneal abrasion, you will not need any other tests. However, if your injury is more serious, your doctor may examine your eye with device called a slit lamp, and also test your vision.

Thursday, 23 February 2012

Corneal Abrasion Fluorescein

C C
(Left) Corneal abrasion stained with fluorescein. (Right) Corneal abrasion stained with fluorescein and highlighted by cobalt blue light.
Image source: www.aafp.org

The diagnosis of corneal abrasion can be confirmed by visualizing the cornea under cobalt-blue filtered light after the application of fluorescein, which will cause the abrasion to appear green.

C

Corneal ulcer in a patient who wears contact lenses.
(Left) View without fluorescein stain. (Right) View with fluorescein stain.
The fluorescent eye test is useful in determining if there is a scratch or other problem with the surface of the cornea. It can also be used to detect foreign bodies on the surface of the eye, and determine if there is an injury to the eye or eye infection. The test is performed by administering dye onto the eye's surface. After the dye has thoroughly covered the eye a cobalt blue light is then directed on the eye. The light causes the dye to glow green. Abnormalities in the corneal epithelium will cause the dye to stain that region.

Fluorescein is a yellow-orange dye that is visible even when it is highly diluted. In ophthalmology, fluorescein is used in conjunction with blue light to detect foreign bodies in the eye and damage to the cornea. A test called angiography uses fluorescein to view blood flow in the retina and choroid of the eye, as well as to identify vascular disorders in the legs and other parts of the body. This dye also is used extensively in biochemical research.

Dog Corneal Ucler: Cat Corneal Ucler

Ulcers of the cornea in dogs and cats is a common occurrence, and a potentially dangerous affliction. Any abrasion to the cornea, including an bee sting, rub from a paw, a scratch from a claw or thorn or an invasive infection can abrade the cells on the surface of the dog or cat cornea. Once the surface cells are disrupted the smooth surface of the cornea becomes rough, infective organisms can invaded the spaces between the cells and the area becomes a source of pain and irritation to the animal. Dogs and cats with corneal ulcers commonly will have increased tear production, will squint (called blepharospasm) and rub at their eye. The irritated tissues often become infected.


Dog Corneal Ucler picture

If infection progresses into the thin cellular layers of the cornea, the ulcer may deepen and widen and eventually break through the membrane at the back of the cornea called Descemet's membrane. In these severe cases, the fluid from the anterior chamber of the eye can escape and the front of the eye collapses. When this occurs, called a descemetocele, the iris will often seal the hole in the cornea. If the iris tissue adheres to the opening and acts as a plug, the anterior chamber may refill and eventually the ulcer may heal and seal the opening in the cornea. This could take many weeks to occur. In unfortunate cases, the interior of the eye can become infected and eventually the eye may be damaged beyond repair.

Once the cornea is abraded, the entire cornea suffers from swelling (called edema) and the cornea takes on a slight haze. Then tiny capillaries begin to move over the cornea from the white of the eye (called the sclera) and seek out the damaged tissue. Within days of the abrasion these tiny vessels are on their way to bring healing tissues and fluid to the ulcer. As specialized corneal cells slide into and fill the defect, the ulcer eventually heals and the surface of the cornea returns to normal. Then the healing capillaries dry up and go away!

Clinical Signs
Corneal ulcers are extremely painful and may cause your pet to avoid bright lights. Clinical signs also include squinting, watering or redness of the eye and a visible cloudy spot on the surface of the eye.

Diagnosis
The most immediate diagnosis of a corneal ulcer is a fluoroscein dye test. The dye is placed on the surface of the eye to "highlight" the corneal ulcer. This test helps your veterinarian determine the size and depth of the ulcer. If your veterinarian suspects an underlying cause, like dry eye, other tests may also be recommended

Treatment
Most veterinarians will begin treating corneal ulcers in dogs and cats with appropriate antibiotic ointment or drops. The use of cortisone or cortisone-related medications may not be a good choice to use due to the possibility of delayed healing and a worsening of the ulcer. It pain is evident, Atropine or other antispasmodic medications may also be dispensed.

The dog or cat's dewclaw, if present, may need to be bandaged to prevent the dewclaw from doing further damage to the irritated cornea as the patient wipes across the offending eye.

Rechecking the eye in five days and then another five days usually demonstrates that proper healing has taken place. A negative stain uptake upon use of the Fluorescein stain will indicate if additional treatment is needed.

Some breeds of dogs, notoriously Boxers and Boston Terriers, often have very unresponsive corneal healing activity.

These cases of poorly healing corneal ulceration need to be monitored closely and special selection of adjunctive medications, such as topical Vitamin E and other medications, may need to be tried to stimulate corneal epithelium regeneration.

Third Eyelid Flap Surgery
Occasionally when a corneal ulcer fails to heal or when a very deep or wide ulcer is present a third eyelid flap procedure is performed.

Under general anesthesia the patient's Nictitating Membrane...also spelled Nictating Membrane... (called the third eyelid) that originates in the medial corner of the eye opening and under the lower lid, is pulled up and over the cornea.

It is sutured to the inside of the upper eyelid, thus forming a protective and nourishing layer of tissue over the damaged cornea. Medications can still be applied to the eye between the eyelids, but the surface of the cornea will not be exposed and cannot be visualized while the third eyelid flap is in place.

The sutures are removed in 10 to 28 days and the corneal healing is assessed. This procedure is commonly done and be very helpful in generating a healing response in severely damaged corneas.

Source: www.worldclassgsd.com

Note: The consultation with your Veterinarian is the best source of health advice for your individual pet.

Wednesday, 22 February 2012

Corneal Abrasion Complications

Abrasions can also hide tiny penetrating wounds of the eye, causing them to be missed during the exam. Delays in seeking treatment enhance the potential for infection or development of other serious complications, such as scarring or infected corneal ulcers. These conditions can cause permanent visual impairment or total loss of vision. If the individual is taking corticosteroids to reduce inflammation related to other conditions, healing response can be significantly delayed or impaired. The incomplete healing of serious corneal abrasions may cause symptoms to recur intermittently (recurrent corneal erosion) over a period of months or years.

Individuals who wear contact lenses overnight or for several days without removing them (extended wear) and who do not properly clean contact lenses risk repeated incidents of corneal abrasion. Improper contact lens hygiene can also lead to infection accompanying the abrasion, which will extend recovery time.

Complications and sequelae of Corneal abrasion from the Diseases Database include:
  • Blepharospasm
  • Eye red
  • Eye pain
  • Photophobia

Dog Corneal Abrasion

How to Handle a Dog Corneal Abrasion

Dogs are just like people in the sense that they can develop vision problems which are often associated with a medical condition. Dogs are very susceptible to infections and disease much like people are and they can have long-term health effects if not treated.

Your dog's eyes can be exposed to a variety of irritants and potential sources for injury on a daily basis, particularly if your dog spends time outdoors. While running through the backyard to bark at the neighbor's cat, your dog could scratch the surface of his eye on a bush or a loose tree. If he rides in the car with the window down, there's the potential for his eyes to be irritated or abraded by debris that hits his face from the wind pressure created by the movement of the car. Dogs can also abrade their eye when they use their paws to scratch their face or neck. In cases such as this, the result can be a dog corneal abrasion which can not only be extremely painful but can lead to a corneal ulceration if left untreated. For this reason, suspected eye irritation or trauma in dogs should be taken seriously and treated aggressively.

How can you tell if your dog is developing a corneal abrasion that needs evaluation?

Some signs to look for include a discharge coming from the eye and redness. You may also notice your dog rubbing at his eye with his paw, squinting, or repeatedly blinking the affected eye. If you observe these signs, it's important to call your vet immediately.

To make the diagnosis of dog corneal abrasion, your vet will stain the affected eye with a special fluorescent stain which allows the abraded area to be visualized when viewed under a special ultraviolet lamp. The eye is anesthetized with a drop of lidocaine before staining which means your dog should feel no pain during the procedure. This test is usually quite accurate and if there's any question, your vet will most likely initiate treatment just to be sure.

How is a dog corneal abrasion treated? How aggressively your dog is treated for a corneal abrasion depends on the depth of the injury. A superficial corneal abrasion can usually be treated with antibiotic ointments applied directly to the eye every few hours. If the abrasion is deep, more intensive treatment may be necessary which may require hospitalization. Fortunately, uncomplicated, superficial corneal abrasions usually heal with antibiotic ointment in several days although some may take up to ten days. During this time, it's important to keep your dog from scratching at his eyes and keep him indoors to reduce the risk of re-injury.

One way to protect your dog from developing a corneal abrasion is to not allow him to hang his head out the car window when the car is moving. Not only is this dangerous in the event an accident occurs, it also increases the risk of sustaining a corneal abrasion. Always be suspicious of any repeated attempts on the part of your dog to rub at his eye with his paws as this can indicate an undiagnosed eye injury. By being aware of any changes in your dog's behavior, you can get your dog treated quickly if he should develop the signs of a dog corneal abrasion.

Published by Kristie Leong M.D. - Featured Contributor in Health & Wellness - Yahoo Voice

Tuesday, 21 February 2012

Eye Drops For Corneal Abrasion

Before using Eye Drops:

Some medical conditions may interact with Eye Drops. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
  • If you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have narrow-angle glaucoma, an overactive thyroid, or high blood pressure

Some MEDICINES MAY INTERACT with Eye Drops. Tell your health care provider if you are taking any other medicines, especially any of the following:
  • Furazolidone and MAO inhibitors (eg, phenelzine) because side effects, such as headache, high blood pressure, and elevated body temperature, may occur
  • Tricyclic antidepressants (eg, amitriptyline) because they may decrease Visine Eye Drops's effectiveness
  • Bromocriptine or catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone, St. John's wort) because their actions and side effects may be increased by Visine Eye Drops
This may not be a complete list of all interactions that may occur. Ask your health care provider if Eye Drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

A list of some types of eye drops in the market link >> Eye Drops

Corneal Abrasions in Children


Corneal Abrasions in Children


A pitiful site isn’t it? I thought so too! She broke my heart all day long. It started at 3:30 am when she came running to my room screaming, “I scratched my eye! I scratched my eye!” I pulled her to me and saw that she was rubbing her eye like crazy with the corner of her blankie. I thought that might be the problem but she distinctly corrected me saying that her fingernail scratched her eye and that the blankie was helping. Who was I to argue?

This sounded classically like a corneal abrasion, a scratch or injury to the cornea, the clear surface that covers the front of the eye. It can be very common in kids and presents often with symptoms of eye pain, tearing, and light sensitivity. Because I never delay treatment when it comes to the eye – and neither should you- I took her to go see her Daddy. Lucky for us he’s an Ophthalmologist. We talked all about her fears before we got there: “No, he won’t cut on you. No, there are no shots. No he won’t poke your eye out.” She seemed a little reassured but still clung to me.

It was a relatively easy examination because of the mixture of anesthesia and fluorescein stain drops he put in her eye. I was surprised to see that – no kidding- within seconds she was back to normal. “How long does this last?”, I asked hopefully. “Only about 15 minutes”, he replied. It was just long enough for him to get his exam. The stain allowed him to see the scratch when viewed with a special light. And, as he said, it looked like she’d caught her fingernail on the cornea and peeled a piece of it off like wallpaper. After he prescribed some antibiotic ointment to prevent infection, placed a patch over her eye for comfort, she was my shadow for the rest of the day.

She did great despite my fear that she would cry all day long. My oldest hovered over her. It was such a cute site to see her leading her by the hand. For once there was no fighting! My youngest, however did his best to antagonize her; He kept leaning over and ripping the patch off. Poor thing! But within 12 hours she was feeling better. And by the next day you’d never know that anything was wrong!

by Sheila Cason MD
Source: www.wellsphere.com

Monday, 20 February 2012

Severe Corneal Abrasion

The cornea is a transparent cover over the anterior part of the eye that serves several purposes, such as protection, refraction, and filtration of some ultraviolet light. This structure has no blood vessels and receives nutrients through tears as well as from the aqueous humor. The cornea is innervated primarily by the ophthalmic division of the trigeminal nerve and the oculomotor nerve.

Although the exact frequency of emergency department visits for corneal abrasions is unknown, a 1985 survey showed that around 3% of all cases to US general practitioners were corneal abrasions. In addition, in 2008, approximately 27,450 work-related eye injuries and illnesses occurred that caused missed time from work. See the following image

Patients with corneal abrasions are managed on an outpatient basis. Emergent ophthalmologic consultation is warranted for suspected retained intraocular foreign bodies. Urgent consultation is needed for suspected corneal ulcerations (microbial keratitis) (see the image below).
Corneal keratitis and staining.

See also corneal abrasion treatment

Corneal Abrasion Healing

The cornea is the clear curved structure found at the front of the eye. It is comprised of three layers and the membranes that separate these layers. It is very difficult to penetrate past the epithelium or top layer of the cornea. The cornea is normally devoid of blood vessels yet has many sensory nerves. When any trauma to the corneal epithelium occurs, cells are lost or destroyed and pain is immediately sensed. When a corneal abrasion occurs, the conjunctiva, or the white of the eye, turns red, as new blood vessels form and those present enlarge, in an attempt to increase blood flow to the eye as it attempts to bring to the eye those cells needed for the healing of the cornea.

Corneal Abrasion Healing

A corneal abrasion heals by the movement of neighboring epithelial cells, which slide over the wounded area, and through a cell division process called mitosis, which fill in the abraded area with new epithelial cells. Within two to three days of trauma to the cornea, these new cells start to adhere to the underlying membrane of the epithelium, called the basement membrane and within seven to eight days the abraded area usually heals completely without scarring. But if a corneal abrasion is deep and penetrates the next layer of the cornea, then scarring is possible and complete healing of the abrasion may be delayed as long as three months.

Sunday, 19 February 2012

Recurrent Corneal Abrasion Treatment

Recurrent Corneal Abrasion is an eye disorder in which the person suffers from frequent episodes of corneal abrasion in a year. This clearly indicates that previous body abrasions did not heal properly. People with dry eye or other eye problems such as corneal dystrophy also tend to suffer from recurrent corneal abrasion. In order to prevent recurrent corneal erosion, one can install a humidifier to ensure that the surrounding air remains humid and not dry. Those who have had corneal abrasion, should wear protective glasses while roaming in the sun or playing with children. Use of eye ointments such as Lacri-Lube daily before sleeping can also be beneficial to prevent return of corneal abrasion.

Most importantly, while undergoing corneal abrasion treatment, rubbing the eye affected with corneal abrasion should be avoided as it will just make matters worse. The eyeball should not be touched with cotton swabs or tweezers as they can cause eye infection. Even if the foreign object is trapped in the eye ball, avoid touching it as it can simply aggravate this injury.

Recurrent Corneal Abrasion Treatment
:

Warm compress
  • Use clean face cloth soaked in warm water, as hot as your eyelids can stand.
  • Bathe your eye (closed) for 5-10 minutes. Rewarm the cloth if it gets cold. This makes the debris easier to remove, as below.
Clean eyelids
  • Clean the edge of your eyelids (the eyelash edge) with a wet cotton bud.
  • Gently scrape off the debris moving the bud side to side.
  • Looking in a mirror, pull your lower eyelid down with the index finger of one hand, and gently but firmly wipe the bud along the edge of the lid to scrape the debris off.
  • With your chin up try the same on the upper, but this is harder.

Cleaning the eyelids

  • First try warm sterile water, that is boiled water allowed to cool but still warm. (Warm tap water is usually quite safe.)
  • Some people recommend a bicarbonate solution instead of plain water. Use a teaspoon of bicarbonate of soda, available from a chemist or supermarket bakery sections, to a pint of water. You can use this solution for a few days, keeping it in the fridge. Use a small amount each time.
  • Using baby shampoo may help. Place a few frops in a pint of water to dilute it first.
  • An antibiotic cream may help (as above); this can be squirted into the eye, or squirted onto your finger, and you can then spread it over the eyelids. Alternatively, apply the ointment with the cotton bud onto the eyelid.
  • may be a healthy diet will help

Bandage Contact Lens Corneal Abrasion

Bandage contact lenses can protect the eyes and increase comfort for patients with damaged or compromised corneas. When patients present with corneal damage due to injury or disease, bandage contact lenses can promote healing and reduce discomfort. Bandage contact lenses not only protect the eye from external assault, they also isolate the corneal surface from friction during blinking. Additionally, unlike other protective methods, such as pressure patching, bandage contact lenses allow medication to be easily instilled.

New Materials

Designed to speed healing and protect a compromised ocular surface or cornea, therapeutic contact lenses have been available for some time. In recent years, some soft cosmetic contact lenses—both daily and extended wear—have also become FDA-approved for therapeutic use. Made of silicone hydrogel materials that allow for a high degree of oxygen transmission, these lenses are now available in plano power for therapeutic purposes.

Over the past few years, I have used the Acuvue® Oasys™ brand as bandage contact lenses, and our Center was part of the study that led to the FDA approval of this lens for thereapuetic use in 2007. The lens is extremely comfortable for patients (in both therapeutic and cosmetic wear), and patients with mild to moderate dry eye are candidates for this lens technology as it is made of a highly wettable material. An additional benefit is the lens’ UV-blocking properties, as it blocks up to 86% of UVA and almost 100% of UVB. I still remind my patients to wear sunglasses outside, however, as I practice in south Florida where there is the potential for high levels of UV exposure.

Uses and Indications

Bandage contact lenses are essential for ablative procedures like PRK and PTK. Following these procedures, bandage contact lenses provide a protective environment to help speed epithelialization, as well as reduce pain and ocular surface irritation. I place a bandage lens on the eye immediately after surgery and instruct the patient to leave it in until I remove it at a follow-up visit 4 to 5 days postoperatively.

In addition to excimer laser surgery, I use bandage contact lenses for virtually any type of abrasion or recurrent corneal erosion. Bandage lenses can significantly reduce discomfort and can help with reepithelialization. Other conditions for which I commonly use bandage contact lenses, and for which Acuvue® Oasys™ lenses are indicated, include bullous keratopathy and filamentary keratitis.

As useful as soft bandage contact lenses may be, there are situations in which they are contraindicated. I am, for example, careful not to use them on eyes that are so dry that the bandage lens might further irritate the ocular surface. In these cases a rigid scleral lens that vaults over the cornea without touching it is usually a better option.

Medication

Bandage contact lenses are, in my opinion, superior to other protective options (eg, pressure patches) in one respect: with bandage lenses patients can easily instill eye drops. Bandage lenses may also potentially act as a reservoir for topical medications, increasing the amount of time a medication stays in contact with the eye.

Antibiotic prophylaxis is needed any time a bandage contact lens is used over a corneal abrasion or erosion and whenever one is used postoperatively. For an abrasion or erosion, a fluoroquinolone can be given 3 or 4 times a day, depending on the fluoroquinolone used. Likewise, after PRK or PTK, patients need to use topical antibiotics and nonpreserved artificial tears on a frequent basis.

After placing bandage lenses, I counsel patients to call the office immediately if there are signs or symptoms of corneal infection (eg, pain, reduction of vision, photophobia, etc.). Despite using prophylaxis, it is important to remain vigilant for signs of infection, as infection can lead to corneal scarring and vision loss.

THE BOTTOM LINE

Bandage contact lenses promote healing, serve as a protective barrier, and reduce discomfort in eyes that have been ablated, have a corneal abrasion or erosion, or have conditions such as bullous keratopathy or filamentary keratitis. I use Acuvue® Oasys™ contact lenses, which have excellent oxygen transmissibility and are FDA approved for therapeutic use. Eyes that have had surgery or which have an erosion or abrasion require antibiotic prophylaxis to prevent infection. Unlike other protective options, bandage contact lenses allow for easy drop instillation.

Source: www.eyecareeducators.com
Reference: www.indiamart.com

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