Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
The Eye
The eye is truly a miracle. Equipped with an ability to
interpret many wavelengths of light, just like a camera, it
can also adapt to darkness, and see from the side. It comes
with a self cleaning mechanism as well. Not just a mechanical
device, it also comes in a variety of designer colors.
It is hard to imagine a world without sight, but many serious
diseases can lead to this feared complication. The commonest
causes of blindness are glaucoma, diabetes, cataracts and
macular degeneration.
Glaucoma is a defect in the drainage system of the inner
workings of the eye. People over the age of fifty should have
yearly screening for glaucoma from their eye doctor. Diabetes
can cause blindness through disease of the small vessels in
the eyes. These two problems along with tears in the retina
(the area of the eye that absorbs the light) can often be
treated with laser treatments.
Cataracts are simply cloudiness of the lens which occurs with
age. A common operation usually takes care of this problem.
Macular degeneration occurs more commonly in smokers, but
anyone can get it and little can be done.
The cornea is the covering of the colored part of the eye,
and it can often be scratched, especially when a person is
"poked" in the eye. While the treatment is straightforward,
it is somewhat painful. Drops are put in the eye to help with
pain and prevent infection. We no longer patch the eye.
Burns of the eye usually affect this portion of the eye as
well, and the treatment is the same, although chemicals need
to be washed out of the eye thoroughly. Alkali burns (oven
cleaners, Drano, lye) need aggressive treatment and massive
amounts of irrigation. Acids (battery acid, Liquid Plumber)
also need vigorous irrigation but there is less damage. In
any exposure of the eye, even shampoo or sand which don't
cause damage, washing out the eye is the treatment. Rubbing
the eye can make things worse.
A real danger is foreign bodies that penetrate the eye, as
the covering of the eye may close over the hole of entry. If
the penetration is deep, serious infection can occur. We most
often see this when a metal splinter enters the eye when
someone is banging metal on metal. Eye protection is a must
when working with metal. Sparks, sand, dirt and twigs usually
don't penetrate that deeply. Welders often burn the covering
of the eye if they do not use protective eyewear, this is a
result of the ultraviolet light of the torch. While welding
looks interesting spectators, especially young children
passing construction sites, should be told not to look at the
flash.
Occasionally, high blood pressure or trauma causes the whole
white of the eye to fill with blood. This is terrible
looking, but no treatment is necessary.
Infections range from the simple to the life threatening.
Conjunctivitis or pink eye is the most common and simplest to
treat -- virtually all antibiotic drops or creams help. In
general, the drops are easier to give but may sting. Creams
are more comfortable, but require a second person's help. A
hordoleum, or a sty, is simply a pimple in the pore of an
eyelash. Warm soaks are all that are required. There are
other infections and blood vessel problems that rarely occur,
but we are out of space. Write me in care of the Yated.
We have spoken about the flu in this column before, and
Glaxo has a new drug for the flu. It is called Relenza, and
it is the first drug that works against all major flu. Not a
antibiotic, but actually an anti-viral. Because it is in
inhaler form, it works directly on the site of infection. Ask
your doctor about it.
