Looking at the prevention and treatment of eye injuries.
ACCIDENTAL eye injury is one of the most common causes of visual loss worldwide, and is a significant health problem.
In the US, it is estimated that nearly two million eye injuries occur annually, and most can be prevented. The leading causes of injuries are sports accidents, fireworks, household chemicals, battery acid, and foreign bodies from workshops or factories.
It can happen anywhere, and more than half of all eye injuries occur in those aged below 30 years old.
Eye injury can be broadly divided into two main categories: trauma from physical injury; and chemical injury. Eye injuries can occur at home, work, or while playing sports. It can, of course, also occur to soldiers during combat.
It is estimated that more than 40% of eye injuries occur at home. If you have young children at home, you should ensure that all sharp corners and objects in the house are protected by a cover or kept out of reach.
Table top corners are the perfect height for a young child to walk straight into, and I have come across some serious eye injuries in children from this.
My own four-year-old daughter’s eye narrowly missed the corner of the living room glass table when she fell off the sofa one day. The corner was not covered and it caused a large cut in her ear lobe.
You can get special protectors for sharp corners from most home appliances shops, but my wife just stuck some sponge with masking tape on all sharp corners after that near miss!
If you are using household chemicals like bleach to clean the house, you should take care when opening the container, as the strong fumes can be powerful enough to damage your skin and eyes.
When pouring out strong chemicals, make sure you are in a well-ventilated area. When spraying any chemicals, make sure that the nozzle is pointing away from you. Ideally, you should wear goggles when using strong chemicals at home, but in reality, that is not always possible.
Another common chemical eye injury I often come across is in contact lens wearers when they mistakenly rinse their contact lenses in some other chemical solution found in the bathroom. Any chemical injury to your eye should be treated immediately with copious irrigation using clean water and, after that, medical advice should be sought.
Of late, tear gas eye injuries have been in the spotlight abroad, and also, locally. Tear gas is a chemical warfare and riot control agent that has been in use since 1917. The most commonly used agent is CS gas, which is an irritant to skin and mucous membranes. It causes immediate and severe tearing, which can last for up to half an hour. It is very effective as a crowd control agent.
At room temperature, it is a white solid substance, and is easily converted into a gas when heated up by shooting it out of a gun.
CS gas can be easily washed out of the eye and skin with water. It is a mild acid, so eating alkaline agents like salt can help neutralise any ingested tear gas in our body.
The tear gas canisters themselves can cause serious injury to the eye and elsewhere if they are shot directly at a person.
After the gas has subsided, the tearing agents can still be present in solid form on the roads and sidewalks, and can be stirred up by wind or traffic.
Interestingly, animals like horses and dogs are not affected, and are often used by riot police when tear gas is used. There are usually no long term effects to your eyes after exposure to tear gas, although there have been reports of burns to the eye due to the heat of the tear gas agents when it was released from the canisters.
Sports injuries to the eye in Malaysia is very common due to our love of badminton and squash. Both are sports where the ball or shuttlecock come at us at very high speeds, and if it hits the eye, damage can be very severe.
To prevent such injuries, we should wear special protective eye wear that have hard-to-break frames and lenses. The lenses are made of shatter-proof polycarbonate, and can be made to any spectacle prescription.
Wearing your normal spectacles when playing is not enough as the frame or lens may shatter when the ball hits it, and the fragments may then enter your eye.
I do get funny looks when I play racquet games with my sports goggles, but it has prevented me from getting any eye injuries all these years. I have been hit by the ball in the face more than once, especially when playing doubles badminton.
Even famous sports stars like Edgar Davids and Janko Tipsarevic wear protective sports goggles while playing high level competitive football and tennis respectively.
Firework injuries to the eye are more common around any festive season and can cause very severe damage. Unfortunately, most of those affected by exploding fireworks are children. Very often, there is very little the eye surgeon can do to repair the eye after such injuries, as damage is usually extensive and involves the whole eyeball.
It is particularly tragic when both eyes are damaged by the explosion.
Even though such fireworks are banned in Malaysia, enforcement remains lax and firework eye injuries will continue to happen at every festive occasion. Parents have to be responsible enough to ensure that their children are not playing with dangerous fireworks on their own.
Eye injuries at work usually happen to manual workers at the construction site, factory or workshop. Welding metal is quite hazardous as there are often bits of metal flying about which can enter the eye, and many countries have made it mandatory for workers to wear protective goggles when working with metal.
Unfortunately, such health and safety regulations are still lacking in Malaysia, and I come across several cases a year of metal foreign bodies entering the eyes of manual workers.
These cases require extensive vitreoretinal surgery to remove the foreign body and repair the eye. Sometimes, vision cannot be saved. In all those cases, prevention by wearing protective eye wear would have been the best thing.
In summary, eye trauma from physical or chemical injury remains a major cause of loss of vision worldwide. It tends to occur in younger people, and usually occurs at home.
Preventive steps like wearing protective eye wear when playing high impact sports or working with metal can help prevent serious injury to your eyes.
Any chemical injury should be treated immediately with irrigation using water.
Very mild trauma to your eyes can cause severe damage and you should seek expert advice for any type of eye injury. For further information, please check out my blog: eyeretina.my.
Dr Fong Choong Sian is a consultant ophthalmologist while Goo Chui Hoong is a consultant dietitian. They will be publishing a book on eye health and diet soon. For further information, e-mail firstname.lastname@example.org. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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