Eye Pain – Eye Disorders

Doctors ask the person to describe the pain, including when it started, how severe it is, and whether it hurts to look in different directions or blink. They ask about whether the person has ever had eye pain and whether the person is sensitive to light, has blurred vision, or feels as if the eye contains a foreign object.

During the physical examination, doctors check for the presence of fever or a runny nose. They check the face for tenderness.

Most important is the eye examination, including the entire eye, eyelids, and the region around the eye. Doctors check

• Whether the eyes are red or swollen

• How clearly a person can see using a standard eye chart (visual acuity)

• Whether the person can see in each part of the field of vision (visual field testing)

• How the pupils react to light

• Whether shining a light into the unaffected eye causes pain in the affected eye when the affected eye is closed (called true photophobia)

If doctors suspect a foreign object but do not see one, they turn the eyelids inside out to search for hidden foreign objects.

Doctors usually do a slit-lamp examination What Is a Slit Lamp? A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2… read more . A slit lamp is an instrument that enables a doctor to examine the eye under high magnification. Doctors place a drop of fluorescein stain on the cornea to show scratches or certain kinds of infection, including ulcers. Doctors use tonometry Tonometry A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2… read more to measure the pressure inside the eye (intraocular pressure). They use a slit-lamp and/or an ophthalmoscope Ophthalmoscopy A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2. .. read more (a light with magnifying lenses that shines into the back of the eye) to examine the lens and use an ophthalmoscope to examine the vitreous humor (the jellylike substance that fills the eyeball), retina (the light-sensing structure at the back of the eye), optic nerve, and the retinal veins and arteries.

Sometimes findings are helpful in making a diagnosis. Particular findings or combinations may point to particular disorders.

Findings may also help suggest or eliminate certain types of disorders.

• Corneal disorders, among other disorders, tend to cause eye redness, tearing, and pain. If those symptoms are absent, a corneal disorder is very unlikely.

• Pain on the surface of the eye, a foreign body sensation, and pain with blinking suggest a foreign object.

• People who wear contact lenses may have a corneal scratch, a corneal ulcer, or contact lens keratitis.

• When measuring eye pressure, doctors put a drop of anesthetic into the eye. If pain then disappears, the cause of pain is probably a corneal disorder.

• Deep, aching, throbbing pain often indicates a possibly serious disorder such as acute closed-angle glaucoma, anterior uveitis, scleritis, endophthalmitis, orbital cellulitis, or orbital pseudotumor. If, in addition, there is eyelid swelling, bulging of the eye, or inability to move the eye to look in all directions, the most likely disorders are orbital pseudotumor, orbital cellulitis, or possibly severe endophthalmitis.

• Fever, chills, and tenderness suggest infections such as orbital cellulitis or sinusitis.

Eye Pain | Causes, diagnosis, treatment, prevention

By Medicover Hospitals / 12 Jan 2021
Home | symptoms | eye-pain

Almost everyone has eye pain at some point. Sometimes they get better on their own, but it is rarely a symptom of a serious condition. Most often, the pain goes away without medication or treatment. Eye pain is also called ophthalmalgia.

Article Context:

1. What is eye pain?
2. Types
3. Causes
4. Diagnosis
5. Treatment
6. When to visit a Doctor?
7. Prevention and Home Remedies
8. FAQ’s

What is eye pain?

Causes:

Ocular Eye pain:

Foreign object:

• The most common cause of eye pain is simply having something in the eye. Whether it’s an eyelash, a piece of dirt, or makeup, having a foreign object in your eye can cause irritation, redness, watery eyes, and pain.

Conjunctivitis:

• The conjunctiva is the tissue that lines the front of the eye and the lower part of the eyelid. It can become infected and inflamed. This is often caused by an allergy or an infection.

Contact lens irritation:

• People who wear contact lenses overnight or do not disinfect them properly are more susceptible to eye pain caused by irritation or infection.

Corneal abrasion:

• The cornea, the transparent surface that covers the eye, is susceptible to injury. When you have a corneal abrasion, it will feel you have something in your eye.

Injury:

• Chemical burns and sudden burns to the eyes can cause significant pain. These burns are usually the result of exposure to irritants such as bleach or overly intense light sources, such as the sun, tanning booths, or materials used in arc welding.

Blepharitis:

• When the sebaceous glands at the edge of the eyelid become irritated or inflamed, blepharitis occurs.

Sty:

• A blepharitis infection can create a lump or bump on the eyelid. This is called a stye or chalazion. A stye can be very painful, and the area around the stye is usually very tender to the touch. A chalazion is usually not painful.

Orbital pain:

Glaucoma:

• This condition occurs when intraocular pressure or pressure inside the eye increases. Nausea, headache, and loss of vision include additional symptoms caused by glaucoma.
• A sudden increase in pressure, called acute angle-closure glaucoma, is an emergency and immediate treatment needed to prevent permanent vision loss.

Optic neuritis:

• You may experience eye pain accompanied by loss of vision if the nerve that connects the back of the eyeball to the brain, known as the optic nerve, becomes inflamed. An autoimmune disease or a bacterial or viral infection can cause inflammation.

Sinusitis:

• A sinus infection can cause pressure to build up behind the eyes. Doing so can cause pain in one or both eyes.

Migraines:

• A common side effect of migraine attacks is eye pain.

Injury:

• Penetrating eye injuries, which can occur when a person is struck with an object or is involved in an accident, can cause significant eye pain.

Iritis:

• Although rare, inflammation in the iris can cause pain inside the eye.

Diagnosis:

• A slit lamp exam uses bright light to look at all the structures in your eye.
• Dilating drops expand your pupil to allow the doctor to see deep into your eye.
• A tonometer is a tool that measures eye pressure, the doctor uses it to diagnose glaucoma.

Images:

Blood test:

Treatment:

Conjunctivitis:

Antibacterial eye drops can cure bacterial conjunctivitis. Antihistamines can strengthen allergic conjunctivitis in the form of eye drops, tablets, or syrup.

Foreign body in the eye:

Blepharitis:

Sinusitis:

Migraines:

When migraine headaches cause eye pain, both can be treated with routine over-the-counter medications, such as ibuprofen (Motrin) and acetaminophen (Tylenol), and prescription migraine medications.

Corneal abrasions:

Glaucoma:

Infected cornea:

Iritis:

Optic neuritis:

Styes:

When to visit a Doctor?

• severe eye pain
• eye pain that doesn’t go away after a few hours
• visual disturbances, such as blurred vision or dark spots
• visible swelling of the eye or nearby tissues
• nausea or vomiting

Prevention and Home Remedies

• Glasses:
• If you wear contact lenses frequently, give your corneas time to heal by wearing your glasses.
• Warm compress:
• Doctors may direct people with blepharitis or a stye to apply warm, wet towels to their eyes. This will help clear the clogged oil gland or hair follicle.
• Redness:
• If a foreign body or chemical gets into your eyes, flush them with water or a saline solution to remove the irritant.
• Antibiotics:
• Oral antibacterial drops and antibiotics can be used to treat eye infections that cause pain, including conjunctivitis and corneal abrasions.
• Antihistamines:
• Eye drops and oral medications can help relieve pain associated with eye allergies.
• Eye drops:
• People with glaucoma can use medicated eye drops to reduce the pressure that builds up in the eyes.
• Corticosteroids:
• For more serious infections, such as optic neuritis and anterior uveitis (iritis), your doctor may prescribe corticosteroids.
• Pain medication:
• If the pain is severe and causes a disruption in your daily life, your doctor may prescribe a pain reliever to help ease the pain until the underlying condition is treated.

Frequently Asked Questions:

When your eyes hurt when moving, it’s most likely because of eyestrain. It could also be because of a sinus infection or injury. Common causes of eyes that hurt when moving include eye strain.

Citations:

Eye Pain – Symptoms, Causes, Related Conditions, Questions & Related Topics

Top 5 Causes of Eye Pain

1. Foreign Item

Plenty of things can cause eye pain, and it’s not uncommon for the culprit to be a foreign item lodged in the eye.^[1] It might be dirt, makeup, an eyelash, or a contact lens that has gotten dry. These items can irritate the eye and make it water or become red. However, it can usually be remedied by taking out the object and rinsing the eye with solution. Hitting the eye with a foreign object can also cause pain, just like any other injury.

2. Eyestrain

If you sit at a computer all day, you might experience eyestrain, which can sometimes make your eyes tired and can even make them hurt.^[2] If this is the case for you, rest and relaxation should help. Try closing your eyes for a while and just letting them rest. If you experience eyestrain while at work, try looking away from the computer for 20 seconds for every 20 minutes that you must focus on it.

3. Dry Eyes

All eyes get dry from time to time, even if you don’t wear contacts or stare at a computer. This can cause your eyes to feel pained, especially when you blink. A good idea is to use some solution meant to soothe eyes in order to minimize pain, dryness, and redness. Usually, dry eye is an issue that can be quickly remedied.

4. Headaches

Some people get headaches right behind their eyes that can be very painful. If this happens to you, it’s a good idea to take some over-the-counter painkillers in order to help your headache subside. If you get headaches extremely often, it could be a symptom of a larger issue. Migraines are very painful headaches that can even cause ocular hallucinations such as shimmering lights and temporarily blurry vision.^[3]

5. Flu

Have you ever had the flu and experienced pain or tenderness in or behind your eyes? This is common because your sinuses often become inflamed and congested when you get the flu. Other signs of the flu are body aches, fatigue, sneezing, and coughing. You may need a doctor’s help if you become dehydrated as a result of the flu, so try to stay hydrated to avoid more dire circumstances.

1. Eye Infection

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One common cause of eye pain is an eye infection introduced by bacteria, viruses, or fungi. Two of the most common types of eye infections are styes and conjunctivitis.^[4] A stye is a bump that occurs in or on the eyelid that makes moving, closing, and opening your eyes painful. Conjunctivitis is the medical term for pink eye, which often occurs in children. Both of these issues might clear up in time or require antibiotics if they worsen. Other signs of an eye infection include discharge coming from the eye, swelling of the eye, itchiness, and redness.

2. Glaucoma

Glaucoma occurs when the optic nerve becomes damaged as a result of diseases, fluid pressure and buildup, or hypertension. A person can become blind if glaucoma is not caught early and treated.^[5] Open-angle glaucoma, the most common type of glaucoma, does not usually cause pain and is difficult to detect, but angle-closure glaucoma, which occurs when fluid cannot drain from the eye and causes an increase in pressure on the eye, can cause severe pain as well as vomiting, redness in the eye, and blurred vision.

3. Uveitis

Uveitis is the term for a number of inflammatory diseases that cause swelling and pain in the eye. Many different issues can cause uveitis, such as an injury or bruise on the eye, infection, or toxins in the eye.^[6] Other symptoms include sensitivity to light, impaired vision, and an increased sensation of floaters or flecks that you can see in your eyes when the vitreous fluid in your eyes begins to shrink.^[7] Treatment might require eye drops, or, in severe cases, intensive medicines such as steroids.

4. Corneal Abrasion

If you injure your eye, there is a possibility that you could have sustained a corneal abrasion, or a scratch on your cornea.^[8] Sometimes, a corneal scratch can heal on its own. Deep scratches, however, can leave scars on the cornea, affecting your vision. It is important to see an eye doctor if you believe you might have scratched your cornea.

5. Optic Neuritis

Optic neuritis is an inflammation of the eye that can cause the optic nerve to sustain severe damage. Optic neuritis can cause intense pain, and in some cases, even temporary loss of vision.^[9] Often, this issue is connected to multiple sclerosis, or MS, which causes a similar type of inflammation in the brain. It is important to go to the doctor if you think you have optic neuritis because this can often be the first sign of MS. Other diseases, like lupus, can also be linked to optic neuritis.

Questions Your Doctor May Ask About Your Eye Pain

• How long have you been dealing with eye pain?
• Do you feel pain in both eyes or just one?
• Is there anything that can cause the pain to worsen?
• Have you experienced any loss of vision or other symptoms?
• Do you work on a computer?
• Do you wear contact lenses?
• Did you injure your eye at all recently?

Eye Pain May Also Be Known as

• Pain in the eye

 

• Ocular pain

 

• Eye discomfort

Differential diagnosis of acute ocular pain: Teleophthalmology during COVID-19 pandemic

Abstract

Ocular pain is a common complaint which forces the patient to seek immediate medical attention. It is the primeval first response of the body to any severe condition of the eye such as trauma, infections and inflammation. The pain can be due to conditions directly affecting the eye and ocular adnexa; or indirect which would manifest as referred pain from other organ structures such as the central nervous system. Paradoxically, there are several minor and non-sight threatening conditions, which also leads to ocular pain and does not merit urgent hospital visits. In this perspective, we intend to provide guidelines to the practising ophthalmologist for teleconsultation when a patient complains of pain with focus on how to differentiate the various diagnoses that can be managed over teleconsultation and those requiring emergency care in the clinic. These guidelines can decrease unnecessary hospital visits, which is the need of the hour in the pandemic era and also beyond. Patients who are under quarantine and those who are unable to travel would be benefitted, and at the same time, the burden of increased patient load in busy hospital systems can be reduced.

Keywords: COVID-19 pandemic, differential diagnosis of ocular pain, ocular pain, telemedicine, teleophthalmology

Ocular pain is one of the most common causes for the patient referral to the emergency clinic.[1] The origin of pain could be from the eye or referred to the eye due to shared innervation with the trigeminal nerve. Some conditions in ophthalmology have classic symptomatology for pain and other associated features such as decreased vision, congestion and photophobia which can lead to a presumptive diagnosis. While examination in the clinic is ideal, it may not be possible always. The patient may be located in a remote area or there may be lack of availability of ophthalmologist. Such a situation is common in countries where the ratio of ophthalmologist to patient can be far lower in a rural versus urban setting. Thomas et al. reported the ophthalmologist-patient ratio in urban India was 1:25,000, but in rural India, it was 1:1:250,000.[2]

Teleconsultation in medicine has been popular in various streams since several years world-over. [3,4] In Indian ophthalmology, its use was limited to community ophthalmology. Now diabetic retinopathy and retinopathy of prematurity (RoP) screening via telemedicine are being routinely used in many institutes.[5,6] With the current pandemic situation due to the COVID-19 infection around the world, the scope and utility of teleophthalmology can be expanded to include screening of the patients’ complaints of pain and thus categorize the patient as an ocular emergency or to be scheduled for routine care. The patient can use a smart phone device to take external photographs of his/her eye and share the same by “WhatsApp” or other similar portals. In simpler conditions, a hospital visit can be avoided altogether by providing simple medical advice over the teleconsultation, decreasing the potential risk of COVID-19 spread.

Many protective measures and guidelines has been developed after emergence of COVID-19 infection. But as per recommendation by the WHO, social distancing is the only possible effective tool to stop its transmission. [7] Ophthalmology clinics are restricting patients numbers to prevent the spread of infection to both patients and healthcare workers. In the absence of vaccines or definitive treatment, it is expected that the disease may be recrudescent in crops and continue even as long as for two years.[8] Teleconsultation, if used effectively and on a large scale, would help reduce the load of patients in the clinic. In this article, we describe the role of teleconsultation for diagnosis of ocular pain. This review will cover most of the common differential diagnoses causing ocular pain.

Process of tele-ophthalmology and instructions for taking photographs with a smart phone

The telephone numbers for teleconsultation should be prominently displayed on the entrance to the premises and updated in print media, official websites or in social media. Based on the availability of personnel in the hospital or the practice, the management can decide on who can answer the call (either doctor or the phone call can be triaged by the hospital staff). In the case of established practices, an electronic consent and a payment gateway can also be created. The doctor will then proceed to take the history and determine the complaints of the patient as pertaining to pain. While on call, the doctor can provide simple instructions for taking a photograph of the eye using the patient’s smart phone as follows:

1. The room illumination should be adequate, and the patient should be facing the light source, such as standing against a window (in case of photophobia, the patient may be able to open the eye only for a short while). The flash should be turned on

2. The “zoom” of the camera should be turned up to 2-2.5 times

3. If the patient is taking his/her own picture: the “selfie mode” can be used, but the regular mode is better

4. The phone should be held horizontal and about 4 inches away from the eye, moving the phone closer to the eye gradually with the patient’s eye looking into the camera located in the back of the phone 4 inches away

5. The person taking the photo should ensure that the eye is well centred and in focus

6. The sender should first review the picture to ensure the image is clear before sending it

7. Based on the condition, the patient/attendant may be asked to take pictures whilst looking in various gazes, or of the eyelids etc

8. Alternatively, the patient can be asked to send a small video clip looking in various gazes.

Ocular trauma

Blunt or penetrating trauma to the eye is a frequently reported ocular emergency. The patient would give a history of injury, and would have mild to moderate or severe pain, based on the nature and force of the injury and the extent of ocular damage. The pain would be in and around the eye and orbit, with swelling of lids, ecchymosis, congestion and subconjunctival haemorrhage []. Lacerations could be located in the lid [] or could include conjunctival tears, corneal lacerations, scleral tears, and globe rupture. The globe could appear disfigured especially in the case of blow out fractures of the orbit. The patient would also report decreased vision, which could be due to penetrating injuries or due to corneal edema, hyphema, lens involvement including traumatic cataract and ruptured lens capsule [Fig. and ], vitreous haemorrhage, retinal detachment, commotio retinae and traumatic optic neuropathy. In the case of trauma, teleophthalmology has a limited role in treatment and the patient would have to report to the hospital immediately.

(a-d) A.50-year old man with pain after injury, note subconjunctival haemorrhage, steamy cornea, dislocated lens into the anterior chamber. (b) Sudden onset pain following trauma to his left eye in a 29-year old. Left upper lid ptosis, with a lid laceration and soft tissue prolapse are noted. He subsequently underwent repair. (c and d) A 23-year-old complained of severe pain after broomstick injury. The image, although of poor quality, shows white matter in the anterior chamber (hydrated lens matter) (c). He was later noted to have ruptured lens capsule and cortical matter in AC (d)

Ocular surface, conjunctiva and cornea

Conjunctival and corneal non-infectious conditions start with pricking sensation and dull pain which is intense on eye movements as the disease progresses. Unlike other ocular causes of pain, the patient’s pain is alleviated with instillation of topical anesthesia due to pain abolishment. Redness, watering and discharge are hallmarks for anterior segment and ocular surface diseases. Additional symptoms may indicate a specific disease process such as: itching and eye rubbing with mucoid discharge and sectoral bulbar congestion point towards allergic eye disease. Acute onset mild pain/irritation with diffuse conjunctival congestion mild discharge indicates viral or bacterial conjunctivitis.

Conjunctival or corneal foreign body

Activities such as hammering, or grinding can result in penetrating trauma and retained intraocular foreign body. Sub-tarsal foreign body should be suspected when the patient has pain on lid movements and is located only on lid eversion. The patient with visible conjunctival non-impacted foreign bodies can be instructed to remove the same with a clean bud gently and washing the eye with clean potable water thereafter, only in the scenario that the patient is unable to visit the hospital. Corneal foreign bodies and deeper conjunctival foreign bodies are best attended to at the hospital emergency room and removal should not be attempted in a non-hospital setting.

Recurrent corneal erosions (RCE)

RCEs usually present acutely with severe pain in the eye and exacerbates on lid movements. It classically occurs on awakening due to sudden forceful opening of lids against the cornea. Past injury with sharp object like fingernail or paper may be elicited, where it would be unilateral or in corneal epithelial or basement membrane dystrophies where bilateral involvement is noted.[9] The patient can be advised to use lubricating eye drops and rest the eye by keeping it closed. In any case, the patient would need to visit the hospital for further management.

Dry eyes

Patients often complain of discomfort due to nociceptive kind of pain, along with sandy/gritty sensation and dryness [Fig. and ]. In severe stages of dry eyes, there is severe pain secondary to ocular surface punctate erosions.[10] Occupational history such as computer professionals, history of prior refractive surgery, and history of systemic conditions such as rheumatoid arthritis or symptoms of dry mouth should be enquired. Milder cases can be managed over teleconsultation.

(a and d) A 45 year old lady complained of bilateral gritty sensation, mild pain and eye rubbing. Mild conjunctival congestion was noted temporally in both eyes, but other findings were normal. She was diagnosed as dry eye, and improved with lubricants. (c and d) 12-year-old child with acute severe pain and unable to open the eye sent this picture which showed dense congestion, central corneal lesion and hypopyon (c). Examination in the emergency clinic conformed infected shield ulcer. Lid eversion showed giant papillae (d), characteristic for vernal keratoconjunctivitits

Pain in children

Children usually cannot express pain and hence it is important to know some of the common causes of pain in children for effective management. These include conjunctival or corneal foreign bodies, allergic eye diseases and phlycten. Allergic eye disease is usually seen in young children, with a chief complaint of eye rubbing. Moderate or severe pain with discharge and photophobia suggest development of shield ulcer or corneal involvement and suggest severe allergic disease [Fig. and ]. Usually, the upper tarsal conjunctival giant papillae can lead to mechanical ptosis of the upper lid which may be noted in the external photograph. Acute onset pain with localized circumcorneal congestion and whitish ulcer is noted with phlycten. It is usually seen with blepharitis or systemic diseases such as tuberculosis. It responds well with topical steroids. The patient would need to be seen in the hospital.

Microbial keratitis

Pain from microbial keratitis is severe due to the rich innervation of cornea. There is associated lid edema, severe congestion, watering, photophobia, defective vision and white spot. Only in rare situations, pain may not be severe (such as in viral neurotrophic keratitis). Lid edema, congestion, corneal scar, hypopyon, and presence of infiltrate can be judged from a good quality photo. However, micro-perforation and depth of the infiltrate is difficult to assess from an image unless it is a descemetocele. Bacteria and fungi together constitute a major portion of the etiology of microbial keratitis []. The ophthalmologist can often be incorrect in making a presumptive diagnosis based on symptoms. Microbiological work-up is considered as the gold standard for diagnosis and management of microbial keratitis patient and has to be done at the earliest. While disproportionate pain has been described in Acanthamoeba keratitis, in Indian patients, severe pain is not reported.[11] In HSV keratitis, the epithelial form (dendritic ulcer) and necrotizing stromal keratitis are the commonest manifestations where patients would present with acute pain and may have previous such episodes or presence of previous corneal scar.[12] In the case of Herpes zoster ophthalmicus (HZO) and keratitis, the classical feature of initial vesicular rash and radicular pain along the ophthalmic dermatome, preceded by a prodrome of burning, dysesthesia and pain should be enquired for on history. Localized pain in and around the eye can occur secondary to keratitis or uveitis []. Post-herpetic neuralgia also occur and lasts for years following complete resolution of the skin rashes. [13] On suspicion of HZO, the patient should be immediately counselled for hospital visit in order to promptly start appropriate therapy and avoid post-herpetic neuralgia and corneal complications. In all cases of infectious keratitis, the patients need to visit the clinic.

(a) Digital picture of a 62-year-old one-eyed patient who complained of severe pain in his left eye following trauma one week ago and loss of vision. The left eye shows an inferior large infiltrate with central thinning and epithelial defect. He was advised to rush immediately to the hospital for further care. (b) 50-year-old patient with history or recurrent severe pain and decreased vision with past history of being diagnoses and treated for HZO with keratouveitis. The shared picture shows evident congestion and corneal haziness due to edema. The patient was advised to start topical corticosteroids and follow up as soon as possible

To summarize, in infectious keratitis, only small (infiltrate < 1 mm), non-visual threatening lesions can be started on initial therapy (broad spectrum antibiotics) till the patient reaches the clinic. With repeated consultation over the next 12-24 hours, and sharing of photographs of the patient’s eye, a few cases can be managed especially in those situation where the patient cannot travel due to lock-down, or is from a highly exposed pandemic area. The other utility of teleconsultation is for follow up. Once the initial consultation has been completed at the clinic, and appropriate microbiological work up is performed, the patient can be started on appropriate therapy and followed up till resolution. Repeat hospital visits can be avoided by daily teleconsultations.

Glaucoma

Glaucoma is usually a painless disease, which has earned it the sobriquet of “silent thief of sight.” In primary open angle glaucoma (POAG), steroid induced glaucoma, creeping ACG, and juvenile open angle glaucoma (JOAG), the Intraocular Pressure (IOP) may be higher but pain is not noted due to the chronic nature. However, there are certain situations in which glaucoma does present with pain and this is usually an ophthalmic emergency. The pain in glaucoma is related to the rapid rise of IOP. Acute angle closure glaucoma (ACG) and secondary glaucomas are more likely to present with pain. Sudden severe pain in the affected eye, with blurred vision (due to corneal edema) and coloured haloes are characteristics of sudden rise of IOP. These halos are seen at twilight, typically around the headlights of oncoming cars and are described as blue-green central and red-orange in the periphery. The pain may be referred to the orbit, head, ears, sinuses, and even teeth (along the distribution of the trigeminal nerve). Autonomic stimulation may result in complaints of nausea, vomiting, sweating, and bradycardia which may at times result in presentations to the general emergency wards before ophthalmic consultation is sought. In a patient with ocular and constitutional symptoms as described above reports with pain, the ophthalmologist should think about glaucoma. If unilateral, the patient can be asked to palpate and compare the two eyes and assess if one eye feels harder than the other. Glaucomatous pain cannot be managed over tele-ophthalmology but instead the patient would definitely need to report to the hospital. In primary angle closure glaucoma, conjunctival congestion, steamy cornea, shallow anterior chamber, vertically oval pupil and some degree of iris sphincter atrophy are present and some of these features may be picked up on a well taken close up picture of the eye. The other eye angles would also be narrow.[14] Certain drugs likeTopiramate can cause secondary angle closure, present with dull or severe pain and blurred vision due to acquired myopia.[15] Hypertensive uveitis would accompanied by ciliary pain and tenderness.[16] Migraine can be associated with normal tension glaucoma.[17]

In summary, the cause of ocular pain may sometimes be glaucoma. While the diagnosis cannot be made for certain (except for acute angle closure in some cases) based on teleconsultation. However, the ophthalmologist may gain several clues from teleophthalmology.

Epicleritis and scleritis

Episcleritis

Episcleritis is inflammation of the vascularised tissue between conjunctiva and sclera. This self-limiting disease is not associated with any complications or visual loss. The condition usually subsides within 2-21 days.[18] The patient would have mild to no pain, or might report tenderness of the affected site. The patient typically reports redness of the eye first noted by family members, rather than the patients themselves, and recurrent episodes are common []. This condition can be treated on tele-consultation with thorough review of history and pain. It has been our clinical observation that this condition was a commonly sought reason for teleconsultation and could be managed successfully without hospital visits.

(a) Smart-phone picture of a 52 year-old-man with mild pain and redness since the past one month with recurrent episodes. The photograph shows diffuse congestion of the temporal episcleral vessels. (b) A 7-year-old boy noted history of severe pain and redness for one week. The photograph shows deep congestion nasally, which was diagnosed as scleritis. (c) A 25-year-old man with recurrent episodes of redness and pain, photophobia, who was being treated as conjunctivitis, the picture taken by the patient shows circumcorneal congestion. With a presumptive diagnosis if uveitis, he was asked to report to the hospital where the diagnosis was confirmed. (d) A 45-year old man reported severe pain since waking up. He was a known patient diagnosed previously as severe dry eye with filamentary keratitis, with chronic ocular graft versus host disease. The photograph sent by the patient is blurred and does not help reach any presumptive diagnosis

Scleritis

Scleritis is characterised by painful inflammation and occurs due to auto-immune process or secondary to infection. If untreated, it can lead to local tissue destruction and visual loss. It is one of the most painful ocular condition and is to be taken care of as an emergency. It is insidious in onset and usually severe in almost all cases (except is some cases of scleromalacia perforans). Analgesics provide only fleeting relief. The patient complains of the pain radiating to the forehead, ear, face, scalp and jaw. It can be severe enough to awaken the patient from sleep at night. Touching the temple or the eye can trigger severe pain and sometimes there can be painful eye movements especially in posterior scleritis.[19,20] During teleconsultation, it is very important to ask the patient to take photographs of the eye not just in primary gaze, but in all gazes with the lids retracted, in order not to miss the pattern of congestion []. Recent history of trauma or surgery to the eye and appearance of a lesion either at the incision site or the injury site can suggest a possible infective etiology. However, management of scleritis would require hospital visits and cannot be managed over teleconsultation.

Uveitis

The pain in uveitis is more often dull aching or throbbing type.[21] Recurrent episodes, subsiding with topical steroids would be characteristic. Acute inflammation causes irritation of the ciliary nerves leading to spasm of ciliary muscles and therefore pain. Specific uveitis entities such as HLA B-27 uveitis, herpetic uveitis or Zoster can also be very painful. [22] Typical history of pain and photophobia, with a densely congested eye without discharge suggest a differential diagnosis of anterior uveitis. The pattern of congestion can be picked up with an external photograph also []. The most frequent misdiagnosis is conjunctivitis (especially in anterior uveitis). Pain in the initial stages is mild in conjunctivitis and gets moderate with associated photophobia if cornea is involved. In addition, conjunctivitis would have lid edema, matting of eye lashes and typical watery or purulent discharge. Other diagnoses to be considered on tele-ophthalmological consultation are other causes of acute red eye such as episcleritis, scleritis, drug toxicity, and angle closure glaucoma. During tele-ophthalmology, not all pictures sent by the patient would be clear enough [] to differentiate the exact pathology and in case of doubt, the patient would need to visit the hospital.

Retinal diseases

Retina is one of the few structures in the body which does not have pain receptors. Hence even if the retina develops tears or detachment there are no symptoms of pain.

Ocular ischemic Syndrome (OIS) may present with pain in 40% of its cases.[23] This may be either due to elevated IOP or ischemia. Pain is usually dull, aching and insidious, and may radiate from periorbital area to face and head and is worse when upright. Since OIS may involve systemic conditions like carotid artery stenosis or giant cell arteritis (GCA), a multidisciplinary approach involving the physician and neurologist is necessary.[23,24] Hence, a hospital visit is essential and urgent considering the likelihood of other systemic comorbidities.

Post-operative endophthalmitis is a rare but serious condition. 75% of the patients present with pain within a week of surgery, hence excess pain in a post-operative patient can be alarming symptom.[25] The pain is severe and can be associated with nausea and vomiting (due to sudden rise in IOP), sudden drop in vision, discharge and swelling of eye lid and adnexa and it necessitates immediate consultation. Endophthalmitis can occur after cataract surgery, glaucoma surgery or even after intravitreal injections.[26] In cases where the patient cannot follow up after surgery, instructions regarding dangerous symptoms should be explained. Teleconsultation should ideally not be a replacement for routine follow-up visits in the long run, but during lockdown periods or those patients suddenly exposed to the COVID-19 virus or in a quarantined patient, telemedicine may be the only consultation available.

Conditions causing severe panuveitis such as Vogt Koyanagi Harada Disease (VKH) in its prodromal phase may be characterised by orbital pain and flu-like illness, followed by bilateral blurring of vision. Examination would show classical features of multiple serous retinal detachments, hyperaemia and edema of disc,[27] but can only be diagnosed after a hospital visit and teleconsultation can help prioritize it at the earliest.

Acute retinal necrosis (ARN) is another severe panuveitic entity (infectious in origin) that may be associated with periorbital pain secondary to inflammation or scleritis followed by loss of vision and warrants emergency visit. [28]

Retinal conditions due to trauma: any penetrating injury needs urgent evaluation at hospital. Blunt trauma can lead to commotio retinae, retinal detachment, macular hole, vitreous haemorrhage. Though all these conditions are painless, trauma per se can cause pain. Diagnosing and treating the retinal sequelae of ocular trauma requires urgent hospital visit.

Neuro-ophthalmology

So far, majority of the conditions discussed above present with pain emanating from the affected eye. However in neuro-ophthalmology conditions, pain can be in the orbital areas accompanied by headache. The most common neurophthalmic conditions associated with eye pain are described.

Optic neuropathies

In optic neuritis the typical pain is acute and dull, with decreased brightness and faded colours;[29] localising to retroorbital, periocular or orbital area with worsening on eye movements (papillitis[30] and visual loss noted subsequently.

In both papilledema and Idiopathic Intracranial Hypertension (IIH), the pain is chronic and dull. The hallmark feature is an associated severe headache which is worse in the morning attributable to raised intracranial pressure.[30,31]

While Non Arteritic Ischemic Optic Neuropathy (NAION) is generally painless, in GCA there is characteristic temporal dull boring pain which precedes the onset of visual loss by a couple of weeks. This pain may be associated with severe temporal headache, scalp tenderness, jaw claudication and pain while chewing.[32]

Eye pain in cranial nerve palsies

In isolated third nerve palsy, there is unilateral stabbing pain with ptosis, outward and downward deviation of the eye [Fig. and ]. In fourth nerve involvement, trochleitis leads to pain on movements and tenderness in the superonasal area.[33] Multiple cranial nerve involvement such as III, IV, V1, V2 and VI^th indicates involvement of the cavernous sinus. These lesions are associated with a stabbing eye pain and a severe headache. The lesions involving the cavernous sinus with characterisation of pain can be grouped as ischemic/compressive (malignant infiltration, lymphoma, infection, cavernous sinus thrombosis) and inflammatory (Tolosa Hunt syndrome). [33,34] An MRI of the brain remains the cornerstone for establishing the correct diagnosis. Horner syndrome has unilateral ptosis and miosis with which may be accompanied with ipsilateral decrease in the corneal sensations.[35]

(a and b) 35-year old man with sudden onset pain and complete drooping of his left eye lid. The picture shows complete ptosis of his left eye (a) and on elevating the lid, the outward position of the eye is very evident (b). The anisocoria is also evident suggesting the diagnosis of third nerve palsy involving the pupil

Eye pain in ocular asthenopia

Uncorrected refractive errors, latent strabismus, anomalies of accommodation and convergence can lead to ocular asthenopia. Asthenopia refers to frontal or periorbital dull chronic eye pain, eye fatigue and burning sensation of eyes associated with frontal headache or brow ache exacerbated with visual effort. Teleconsultation may not aid the primary diagnosis. However, the availability of online software programmes for correcting orthoptic anomalies may be useful in monitoring the resolution of anomalies of accommodation and fusion.

Eye pain in migraine

Migraine is a common headache syndrome which presents as episodic severe unilateral hemicranial headache, variably associated with nausea, vomiting, phonophobia and photophobia. An increased incidence of dry eye disease is found to exist in individuals with migraine, which could be a cause of eye pain in these patients.[36]

To summarize, in this era of pandemic, teleconsultation may help in reducing the clinic visits in neurophthalmic conditions. Based on the initial symptoms, a differential diagnosis can be considered and preliminary investigations can be advised which include appropriate neuroimaging even prior to a physical consultation in some cases, or the patient can be triaged directly to the neurologist. Appropriately guided nine gaze photographs or evaluating ocular motility through video conferencing may aid in diagnosis of the cranial nerve palsies and redirecting them towards the systemic investigations for the suspected etiology, thus cutting down on hospital visits.

Eyelid, orbit and ocular adnexa

Similar to neuro-ophthalmology, in conditions involving the eyelids, adnexa or orbit, the pain may be located around the eye or may be referred pain from the orbit, sinuses or the cranial cavity.[37] Infections and inflammation are commonly associated with pain. Hordeolum or stye[38] is a common cause of lid pain, which has a simple management that helps expedite the resolution of the inflammation.[39] The condition can be easily diagnosed on teleconsultation with the help of a photograph. Eyelid massage for pus point, warm compresses and topical antibiotic ointments help in local control. Other causes of eyelid pain include preseptal cellulitis, which can be diagnosed and managed on teleconsultation as it is frequently allergic and can resolve with oral analgesics and antihistaminics [].

(a) 25 year old female with complaints of left eye sharp/stabbing pain around the left eye with diffuse swelling since 1 day. The picture shows mild edema and ptosis of her left upper eyelid. She was diagnosed as preseptal cellulitis and the condition subsided with oral antibiotics and analgesics. (b) Digital photograph of the patient’s left eye showing acute dacryocystitis presenting with severe pain, swelling and erythema over the lacrimal area and lid edema and discharge

Orbital cellulitis is a common complication of sinusitis and can be associated with sight threatening and intracranial complications.[40] Pain, fever, and malaise are noted. Proptosis, limited extra-ocular motility, chemosis and a dilated pupil suggest orbital involvement. The patients would need to be called in for urgent care as this condition requires an urgent imaging study, CT or MRI is indicated in these patients.

Orbital inflammations such idiopathic orbital inflammatory disease (IOID) and thyroid eye disease (TED) can present with pain.[41] In case of frank features such as proptosis, eyelid retraction, conjunctival congestion and chemosis are noted on teleconsultation, a baseline thyroid function test should be advised, and the patient should report for further management.

Complaints of painful ophthalmoplegia with signs of ocular inflammation[42] can be due to orbital myositis. Dacryoadenitis is the most common inflammatory lesion of the lacrimal gland,[43] with the patient having mild pain and “S” shaped eyelid and inflammatory signs around the lacrimal gland. Orbital vascular lesions, typically the veno-lymphatic malformations, can sometime present with acute proptosis and pain.[43] Rupture of macrocyst or veno-lymphatic malformation (VLM) leads to chocolate cyst causing acute pain, proptosis and exposure keratopathy.[44] Panophthalmitis is an acute, painful, purulent infection of all the coats of the eye and can be secondary to endophthalmitis.[45] The pain is often so severe[46] that it can be relieved only by evisceration. Admission and systemic antibiotics followed by systemic steroids are recommended. Adenoid cystic carcinoma is the most common primary epithelial malignancy of the lacrimal gland.[47] Due to perineural invasion, patients often present with pain. Proptosis with downward and medial displacement of the globe may be seen. Acute dacryocystitis[48] [] presents with pain, erythema of the skin over the lacrimal sac, tearing, discharge and at times abscess formation (which would be very painful), and a draining fistula. Once the acute inflammation resolves dacryocystorhinostomy may be considered. However, nasal surgery during the current coronavirus epidemic carries a higher risk of aerosol transmission and awaiting resolution with medical treatment in the acute phase seems to be advantageous.

In summary, since teleconsultations in eyelid, orbit and adnexal diseases can be instituted by reviewing external photographs of the patients and the dependence on visual acuity testing is relatively limited, tele-ophthalmology seems to hold promise in reducing the requirement for patient travel and the risks involved therein.

Eye pain: Taking the sting out of a sty

Speaking of Health

Tuesday, July 21, 2020

By Mayo Clinic Health System staff

Have you ever woken to discover a red, painful lump near the edge of your eyelid? This lump, which can develop quickly or overnight, is called a sty. It may look like a pimple or boil and be filled with pus.

A sty usually forms on the outside of the eyelid but could also form on the inner part of the eyelid. It may be extremely painful, cause your eyelid to swell and can cause you significant concern.

What is a sty?

A sty, also called a hordeolum, is caused by blocked oil glands in your eyelid. Meibomian glands in your eyelids naturally release oil, which is an important component to trap the tears on your eyes. If these glands become blocked, bacteria can grow. Our lids have naturally occurring bacteria to keep our eyes healthy. A sty can form if you have an overgrowth of bacteria at the same time as blocked glands.

Developing a sty is quite common and impacts people of all ages. Yet, people who have dry eyes or eyelid disease are more prone to sties. Other risk factors include wearing contact lenses or using old or expired makeup.

What is the treatment for a sty?

In most cases, a small sty doesn’t require specific treatment and should go away on its own within a week. Applying a warm compress for 5 to 10 minutes can help with pain and swelling, as well as allowing those blocked glands to better express. Take care to keep the site clean, and don’t use contact lenses or makeup during this time. Wash your hands often, and don’t try to pop or squeeze the pus from a sty. Doing so can cause the infection to spread or worsen scar formation. If an active infection is occurring with the sty, you will need oral antibiotics to help the healing process.

When is a sty cause for concern?

While most sties go away without treatment or evaluation, recurring or medium-to-large sties can be a sign that your eyelids are unhealthy. Ongoing sties can damage the Meibomian glands, which decreases the oily layer. This leads to an increase in evaporation of your tears resulting in dry eye symptoms. Dry eye syndrome can get worse over time and become severe enough that available treatments are not able to help.

If you have recurring or large sties that do not go away in a few days, it’s important to visit a health care provider to discover if they are caused by an underlying eyelid dysfunction.

For the safety of our patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a non-patient care area where social distancing and other safety protocols were followed.

8 Eye Issues You Should Never Ignore

It’s easy to take your eyes for granted. They help you navigate the world and require little in the way of daily maintenance. But when one or both of your eyes begin to bother you, it can become a major distraction.

So how can you tell which eye issues are no biggie and which ones indicate serious trouble?

Ophthalmologists Dr. Jennifer Yu and Dr. Lisa Olmos de Koo of the Eye Institute at Harborview Medical Center and the Karalis Johnson Retina Center at South Lake Union share the deets on which peeper problems you should never ignore.

Eye pain

Eye pain is the most obvious symptom that you shouldn’t ignore. If you’re just minding your own business and your eye suddenly starts to hurt, that’s cause for concern.

If the eye pain comes on suddenly, is severe or lasts for more than a minute or two, see an ophthalmologist right away, says Yu.

That’s because pain may be your eye’s way of alerting you to infection or inflammation. But even if you can chalk the pain up to an eye injury, you still should get it looked at.

“It’s not always easy for someone to assess the degree of injury to their own eye. And it’s not only the trauma to your eye that can be a problem but subsequent swelling, bleeding or infection,” says Olmos de Koo.

Blurry vision

The most common cause of blurry vision is inadequate lubrication of your eyeball. (Sounds lovely, right?)

This condition is aptly named “dry eye” and can result from certain medications such as antihistamines, environmental factors like wind or smoke and even from wearing your contact lenses for too long. Pregnant women are also more likely to experience dry eye because hormonal changes affect the quality of your tears.

Always report any changes in vision during pregnancy to your doctor because it could be a sign of gestational diabetes or high blood pressure. But if you’re not pregnant, an over-the-counter product known as artificial tears (aka eye drops) usually resolves symptoms.

If artificial tears don’t help, make an appointment to see an ophthalmologist within a few days.

“It may just be time to get some prescription eyeglasses, but you want to rule out the possibility of an eye disease,” says Yu.

But if your vision blurs suddenly or you experience a severe drop in vision over the course of minutes or hours, go to the emergency room right away.

That’s because there are some serious health issues, such as inflammation of your optic nerve or very high pressure around your brain and spinal cord, that can lead to sudden vision problems.

Burning or a gritty feeling

A lack of sleep, smoke in the air, allergies or dry eye can sometimes cause a burning or gritty sensation in the eye. Artificial tears can alleviate the sensation.

“But if you suspect an object in your eye is causing the irritation, go to an ophthalmologist. Don’t get anywhere near your eyeball with a pair of tweezers,” says Olmos do Koo.

Sometimes the oil glands that block your eyelashes can get blocked. And sometimes mites — yes, mites — play a role. That’s because these microscopic creatures live in and around the hair follicles of your eyelashes and feed on the dead skin cells and oils that build up there. While they occur naturally, mites can also cause eye issues when there are too many.

There’s a simple home remedy that works to unblock oil glands. Put a washcloth under hot water, squeeze it out and hold it up to your eyelids with your eyes closed for about five minutes to open up blocked oil glands.

If you suspect mites, add a foaming tea tree oil cleanser to your routine, gently lathering your eyelashes and then rinsing.

“Always test to make sure you’re not allergic to it first, but tea tree oil cleanser will kill the mites,” says Yu.

For this treatment to be effective, you must do it every single day for several weeks.

If you still experience a burning or gritty sensation in your eyes after several weeks, make an appointment with an ophthalmologist.

Eye redness

Remember how allergies, smoke in the air and not sleeping enough can cause a burning sensation? Well, those irritants can also make blood vessels in your eye dilate and become more visible.

If your eye is red but feels fine and your vision is unaffected, you can just wait it out or use artificial tears to relieve the irritation. It’s not a great look, but it’s not a crisis.

Dramatic redness can occur if one of your small blood vessels breaks, causing a bright-red patch of blood on the eye.

“It looks alarming, but it’s not. In essence, it’s just a bruise,” says Yu.

It’s when redness is accompanied by pain, burning, blurred vision, discharge or any other new symptom that you should seek out help from an ophthalmologist.

That includes pink eye, a lay person’s term for conjunctivitis, a highly contagious infection dreaded by preschool parents everywhere. Pink eye is redness and inflammation of the membranes covering the eye and the inner surface of the eyelids, most often caused by a virus but sometimes by bacteria.

Your eyes usually itch and have a sticky discharge, especially when you sleep. If you wake up unable to open your eye because it’s crusted together, it’s probably pink eye.

It’s always best to go to your primary care doc or an ophthalmologist to confirm your suspicion. Although viral pink eye will run its course  — usually from a few days to a week — bacterial pink eye is treated with antibiotics. As difficult as it is to keep pink eye from spreading, you should refrain from rubbing or touching your eye. And you should wash your hands with warm soap and water if and when you do.

To alleviate crusting, use a clean washcloth rinsed in cold water as a compress. And don’t forget to use a new washcloth every time. Sigh.

Double vision

From an ophthalmologist’s point of view, there are two types of double vision. (Or three if the ophthalmologist is a Foreigner fan.)

If your double vision resolves when you close one eye, this could result from a neurological problem, and you should go to the ophthalmologist or the emergency room pronto.

When closing one eye doesn’t fix things, it’s likely a result of dry eye or a cataract. For this type of double vision, go to an ophthalmologist instead of the emergency room.

Droopy eyelid

As you get older, your eyelids will droop a bit from gravity and your eye tissues naturally getting loose, but this is a gradual process and not an emergency. If one eyelid suddenly becomes droopy, though, go to the emergency room as this can be a sign of stroke, muscle disease or a nerve problem.

Odd-sized pupils

You probably know that when it’s bright, your pupil shrinks and when it’s dim, your pupil dilates.

No matter how bright or dim it is outside, your pupils should always be symmetrical. If one is suddenly quite large and the other is normal, you should go to the emergency room right away. This could indicate an aneurysm or another serious brain disease.

Floaters accompanied by flashes of light 

Eye floaters are a fact of life. They’re a result of age-related changes that occur within your vitreous, the gel-like substance that fills your eyeball.

But if you suddenly notice a new set of floaters that differ from ones you’ve had before, especially when accompanied by flashes of light or obscured vision, you should go to an ophthalmologist immediately because you may have torn your retina.

As your vitreous ages, it becomes more liquid-y and, through that process, can tug on the retina. If your retina is weak, you can get a tear.

“Most of the time, a retina tear is spontaneous and not a result of injury,” says Olmos de Koo.

Eye care and prevention

Even if you’ve never experienced symptoms like these, don’t turn a blind eye to routine care for your eyes. The American Academy of Ophthalmology recommends a routine eye check by an ophthalmologist by age 40. Over age 40, you should get an eye exam every two to four years.

If you have diabetes, high blood pressure, high cholesterol or other health issues, you’ll want to visit an ophthalmologist more frequently. An ophthalmologist can discern the health of your eyes and the quality of your vision, as well as spot other health problems that show up in your eyes, too.

“We’ve all heard the saying, ‘Your eyes are a window to your soul,’” says Olmos de Koo. “What most people haven’t heard before is that they’re a window into your overall health, too.”

Sore Eyes – Exeter Eye

Eye pain can be a symptom of a number of different conditions, depending on the type and severity of pain.

Dry, sore eyes

Sore eyes combined with a dry, gritty feeling could be caused by dry eye syndrome. Constantly sore and dry eyes may even water more, as the eyes respond to the dryness and irritation with excess tears. See our information on dry eyes and watery eyes for more details.

Itchy, red, sore eyes

Allergies and eye infections can both cause your eyes to feel sore, red and itchy. Often itchy or irritated eyes can become sore after excessive rubbing. The eye infection conjunctivitis is a particularly common cause of sore, red eyes. Contact lens irritation can also cause sore, red eyes.

Sharp eye pain

An injury to the eye or trauma can often cause sharp or stabbing eye pain. In extremely rare cases, sharp or stabbing eye pain can be a symptom of a much more serious condition, such as a brain tumour or aneurysm. However, a much more common cause is simply a headache or migraine that feels as if it is directly behind the eye.

If you experience sudden eye pain combined with blurred vision, halos around lights, nausea or vomiting, it could be a symptom of acute closed-angle glaucoma. This is a medical emergency, and you should seek medical attention straight away.

Dull eye pain

If you experience a dull, aching eye pain, or pain that feels deep within your eye, it may simply be caused by eye strain or overuse of your eyes. However, if the pain does not subside, it could be a symptom of a more serious condition or eye disease such as glaucoma.

Something In Your Eye?

From an eyelash to a dirt particle, we’ve all had something stuck in our eye at one point or another. This can be annoying and sometimes even painful. If you’re tempted to rub your eyelid, STOP! Rubbing the eyelid can cause the particle to scratch the cornea, the clear front surface of your eye. Instead of rubbing, remove the cause safely and effectively by remaining calm and using these tips.

First, blink your eyes quickly to dislodge and free the object. If that does not work, try flushing the eye out using eye drops, or wash your hands, and then flush the eye with water at the sink.

Is the object still stuck? Find the nearest mirror to take a look to see where the particle is. If the item is stuck under the top lid, gently pull the upper lid down and out over the lower lid, and let the lid slide back into place; this might free the object. If the object is in the corner or bottom lid, hold the lower lid open and use a qtip or the corner of a clean tissue to remove it.

Getting something in your eye is very common, but it’s important to remember these tips and to stay calm and be gentle to avoid injuring your eye.

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Treatment for sore eyes

It is important to see your eye specialist or doctor if you encounter eye pain; especially if the pain does not subside. While it is unlikely your sore eyes will be a symptom of a very serious condition, it is still a possibility and you should get an expert diagnosis.

Treatments for sore eyes depends on the cause. It can be as simple as using eye drops or compresses for dry eyes and allergies, to medication and surgery for more serious eye conditions.

Whatever the cause of your eye pain, our specialists at Exeter Eye can help you with expert diagnosis and the most advanced treatments.

To discuss any of the above symptoms book a consultation for an expert diagnosis to look at the possible treatment options by calling us on 01392 699969 or contact us online.

Share this: 90,000 Eye pain – the main causes, methods of diagnosis and treatment

Stock! 20% discount on the initial doctor’s appointment for new patients of the clinic with the “FIRST20” promo code.

Eyes – the leading part of the visual analyzer, helping to perceive up to 80% of all information. Since each eye has a dense network of pain receptors, as well as very sensitive nerve endings, all external and internal processes in the body can affect its health.

The meaning of the term “pain in the eyes” is rather vague. This is due to the fact that it can be difficult to describe single symptoms. Some may call pain a burning sensation or discomfort, someone will note “internal” pain, a feeling of a “foreign body”, and it happens that they come to an ophthalmologist with obvious external signs – redness, swelling and increased lacrimation.

What is the main cause of eye pain? Like symptoms, there can be many diseases: sometimes discomfort is caused by standard fatigue, and sometimes it indicates serious internal pathological processes in the eyes, oculomotor nerves, and in some cases even the brain.

It is possible to avoid serious consequences, the easiest way is to consult an ophthalmologist in a timely manner, at the first symptoms.

The main causes of pain in the eyes

We will tell you about the most common causes that cause eye pain and require medical attention (both preventive and curative). Remember, if the painful sensations are not the result of a gust of wind or eyelashes that have entered the eye, this may be a signal for various diseases and conditions that require immediate action.

• Pressing pain in the eye is usually a sign of increased IOP (intraocular pressure).
• Overwork of the eye muscles, as well as the muscles of the face.
• Ingress of foreign bodies on the surface of the eye, various injuries.
  If you wear contact lenses, an old or unsuitable pair can scratch the eye surface.
  If a foreign body gets into it, bacterial infections that cause inflammation often penetrate along with it.In this case, the best way out is to consult an ophthalmologist.
• Infectious diseases.
  Once bacteria enter the eye, infections may develop. An important point here is that infection can be created not only by the external environment, but also by internal pathologies.
• Inflammatory process in the mucous membrane of the eye.
  Conjunctivitis is accompanied by cutting, constant pain that gets worse when blinking. There is an abundant discharge of tears and pus, photophobia.
• Dry eye syndrome.
  In modern conditions, this disease is increasingly common. Now even young people go to the doctor with symptoms of dry eyes, burning sensation and discomfort. The reasons for this are very simple: long-term work at the computer, air-conditioned rooms, lack of timely prevention.

Important to know!

• An increase in temperature, regardless of its cause, can provoke eye pain.
• When pain is felt in both eyes at once and is accompanied by fever, joint pain, and weakness, you are likely to have the flu.
• If dust, sand grains and other tiny elements get into the eye, it may seem that their size is enormous.
• Pain in the eyes is a sure companion of migraines.
• Dull eye pain occurs with increased blood pressure.

Immediately see an ophthalmologist in the following situations:

• if you have received any, even the smallest eye injury,
• if a foreign body gets into the eye,
• if you experience a sharp deterioration in vision (especially accompanied by headache and weakness),
• if you notice any external changes in the eye area.

All ophthalmologists of our center are professionals in their field. Experience and an individual approach help them accurately diagnose any eye diseases and provide fast and high-quality treatment.

You can make an appointment with an ophthalmologist right now:

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90,000 Why is there pain in the eyes?

Under eye pain
refers to the state when a person moves his eyes and experiences
this is an unpleasant painful sensation.The reasons for this are different, they may indicate
both about eye disease and about concomitant ailments.

Let’s talk about the most
common causes of eye pain:

1. Overvoltage
   visual system. Most often, overvoltage occurs after
   long-term work at the computer, work with small parts, as well as
   indoors with low light.
2. Unsuitable
   glasses or
   contact lenses.If the means for correcting vision are not selected
   right, then the eyes will be tense and tired, which will cause
   pain.
3. Sorinka
   in the eye. Sorinka in the eye can cause severe pain when moving the eye from
   side to side. To get rid of the pain, you need to pull out the foreign
   body.
4. Inflammatory
   eye diseases at an advanced stage. Most inflammations begin with
   redness and discharge.If left untreated, the situation becomes worse, and then
   there is a sharp pain when moving the eyes.
5. Glaucoma.
   This is a very insidious disease, because at first it does not manifest itself in any way, but
   later, there is pain when the eyes are rolling. In this case, you need
   immediately consult a doctor, otherwise, it threatens blindness.

What to do if
do you have pain when you roll your eyes? If you move your eyes, everything becomes
more painful and painful every day, then you should immediately go to the ophthalmologist.When pain occurs as a result of eye strain, you can fight it.
on one’s own:

1. Try
   special moisturizing eye drops. They can help fight dry eyes
   and relieve tension.
2. Make
   compress or eye mask. You can resort to proven folk
   methods: put squeezed tea bags or raw
   potatoes, make a compress from chamomile infusion.And if you don’t have time,
   then use a ready-to-use anti-fatigue gel mask
   eye. Just put it in the refrigerator and then put it on your eyes, it is not only
   relieve the eyes of stress, but also eliminate headaches.

To prevent the occurrence of
painful sensations when moving the eyes, it is recommended:

• do
  eye exercises to help normalize blood circulation and strengthen
  muscles;
• Observe
  hygiene rules, do not touch your eyes with dirty hands;
• enter
  more vegetables and fruits in your diet that contain beneficial for eyesight
  trace elements, try not to abuse food with carbohydrates, spicy and
  sweet food ;,
• Visit an ophthalmologist periodically for examination.

90,000 what is it, causes, symptoms, types and degrees of the disease, diagnosis, prevention and treatment methods

What is astigmatism?

Astigmatism is one of the most common causes of low vision. Often astigmatism is combined with myopia ( myopic astigmatism ) or hyperopia ( hyperopic astigmatism ).

Astigmatism

Astigmatism in Latin is the absence of a (focal) point.Astigmatism occurs due to the irregular (not spherical) shape of the cornea (less often – the lens). In a normal state, the cornea and lens of a healthy eye have an even spherical surface. With astigmatism, their sphericity is impaired. It has different curvatures in different directions. Accordingly, with astigmatism in different meridians of the corneal surface, there is a different refractive power and the image of an object when light rays pass through such a cornea is distorted.

In simple terms, astigmatism is a condition that occurs when the lens or cornea stretches into an elliptical shape, although it should be round in a healthy state. Because of this, the light is not refracted correctly and is not focused in the center of the retina. The image is blurry.

Some areas of the image can focus on the retina, others – behind or in front of it (there are more complex cases). As a result, instead of a normal image, a person sees a distorted one, in which some lines are clear, others are blurry.You can get an idea of ​​this by looking at your distorted reflection in an oval teaspoon. A similar distorted image is formed with astigmatism on the retina.

Specialists distinguish corneal and lens astigmatism . But the influence of corneal astigmatism on vision is greater than that of lens astigmatism, since the cornea has a greater refractive power. The difference in the refraction of the strongest and weakest meridians characterizes the value of astigmatism in diopters.The direction of the meridians will characterize the axis of astigmatism, expressed in degrees.

As a person with astigmatism sees

Astigmatism

Normal vision

Degrees of astigmatism

Experts distinguish three degrees of astigmatism:

• mild astigmatism 90 130 – up to 3 D;
• moderate astigmatism 90 130 – from 3 to 6 D;
• High grade astigmatism 90 130 – above 6 D.

Symptoms of mild astigmatism are often almost invisible, and a person with this type of refractive error can only find out about their diagnosis when examined by an ophthalmologist.

With moderate astigmatism, visual impairment is already becoming noticeable – the more diopters the ailment is characterized by, the more blurry the image will be. Another unpleasant symptom appears: the picture is distorted, and straight lines begin to bend, the outlines of objects “float”.

Astigmatism of a high degree, in addition to visual impairment, is characterized by an increase in symptoms associated with constant visual strain. Dizziness, pain in the eyes, headaches, to one degree or another present in milder degrees of astigmatism, can cause serious discomfort to a person suffering from high degree of astigmatism.

normal image astigmatism distortion

To understand how a person with astigmatism sees, you just need to imagine that the world has suddenly become as if you are looking at it through a crooked mirror.Lines break, become blurry and fuzzy.

Types of astigmatism

By the nature of occurrence, astigmatism is divided into congenital and acquired.

• Congenital astigmatism – up to 0.5 D occurs in most children and refers to “functional”, that is, this type of astigmatism does not affect visual acuity and the development of its binocularity. However, if astigmatism exceeds 1 D or more, then it significantly lowers vision and requires treatment in the form of spectacle correction.
• Acquired astigmatism appears as a result of gross cicatricial changes on the cornea after trauma, injury, surgery on the eyes.

Depending on which refractive error is combined with astigmatism, the following types of this visual impairment are distinguished:

• simple hyperopic or simple myopic astigmatism – a combination of hyperopia or myopia in one meridian of the eyeball and normal refraction in the other;
• complex hyperopic or complex myopic astigmatism – a combination of hyperopia or myopia of varying degrees in the main meridians of the eye;
• mixed astigmatism – a combination of hyperopia in one meridian and myopia in the other.

How to improve vision with astigmatism?

Today, there are three ways to correct astigmatism: glasses, contact lenses and excimer laser correction.

Is it possible to cure astigmatism by gymnastics?

Astigmatism cannot be cured with visual gymnastics. These exercises are aimed at strengthening the oculomotor muscles and relieving tension from the eyes. Astigmatism can be compensated for with spectacle correction, toric contact lenses and laser correction.

Spectacle correction of astigmatism

With astigmatism, special “complex” glasses with special cylindrical lenses are most often prescribed. Experts mention that wearing “complex” glasses in patients with a high degree of astigmatism can cause unpleasant symptoms, such as dizziness, pain in the eyes, visual discomfort. In contrast to simple glasses, in the prescription for astigmatic “complex” glasses, data on the cylinder and the axis of its location appear. It is very important that the patient undergoes a thorough diagnosis before fitting the glasses.As there are often cases when a person diagnosed with astigmatism has to change his glasses several times.

With astigmatism, wearing glasses is not only possible, but also necessary. If not corrected, astigmatism may progress and vision may deteriorate.

It is important to understand that glasses do not cure astigmatism, but only compensate for it. Having removed the glasses, the person will again see the distorted curved lines. You can get rid of astigmatism only with the help of laser vision correction.

Contact lenses for astigmatism

Speaking about the correction of astigmatism with contact lenses, it is important to note that until recently it was possible to correct astigmatism only with the help of rigid contact lenses. This lens model not only caused inconvenience during wearing, but also had a bad effect on the cornea. However, medicine does not stand still and today special toric contact lenses are used to correct astigmatism.

Special astigmatic lenses differ from conventional lenses in that three parameters are important for correct fitting: diopter power, cylinder strength and cylinder axis.Toric lenses are designed specifically to correct visual impairment in astigmatism, and conventional lenses do not fully compensate for them.

For patients with mild astigmatism (0.5-0.75 diopters), regular (non-toric) contact lenses may be prescribed. If astigmatism exceeds 0.75 diopters, astigmatic lenses are indicated.

REMEMBER!

• After prescribing glasses or contact lenses, it is necessary to regularly observe an ophthalmologist for their timely replacement with stronger or weaker ones.
• Glasses and contact lenses are not an option in the fight against the problem of “astigmatism.” These methods correct vision only for a while.

Excimer laser correction of astigmatism

In recent years, excimer laser correction has been most often used to treat astigmatism (up to ± 3.0 D). LASIK laser correction can hardly be called an operation. This procedure is carried out for 10-15 minutes under local drip anesthesia, while the effect of the laser does not exceed 30-40 seconds, depending on the complexity of the case.

During vision correction by the LASIK method, a special device – a microkeratome – separates the surface layers of the cornea 130–150 microns thick, giving the laser beam access to its deeper layers. Then the laser vaporizes part of the cornea, the flap is returned to its place and fixed by collagen, the cornea’s own substance. No suturing is required as the epithelium along the edge of the flap is restored naturally. After vision correction using the LASIK method, the rehabilitation period is minimal.The patient begins to see well within 1–2 hours after the procedure, and finally his vision is restored within a week.

At a consultation with an ophthalmologist, many people ask: is it necessary to correct mild astigmatism? A weak degree of astigmatism does not exceed 1 diopter and it is really not necessary to compensate for it. But if even mild astigmatism affects the quality of vision and causes discomfort, then it is important to correct it.

What is the danger of astigmatism

If astigmatism is left untreated, it can lead to strabismus and a sharp drop in vision.Without correction, astigmatism can cause headaches and pain in the eyes. Therefore, it is very important to visit your ophthalmologist regularly.

What not to do with astigmatism?

With astigmatism, you can play sports, but you can not lift weights, avoid sharp bends and strong muscle tension (for example, when doing weightlifting, in the gym). This can negatively affect intraocular pressure. With high degrees of astigmatism, it is not recommended to engage in those sports that require teamwork due to problems with orientation in space.

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See also:

Leading ophthalmic surgeon and medical director of the Excimer clinics, doctor of the highest category, doctor of medical sciences, professor, academician of the Russian Academy of Natural Sciences

Work experience 36 years

Chief physician of the Moscow ophthalmological clinic “Excimer”, ophthalmic surgeon of the highest category, Doctor of Medical Sciences, Associate Professor, Academician of the Russian Academy of Natural Sciences

Work experience 45 years

Ophthalmic surgeon, candidate of medical sciences

Work experience 28 years

Pressing questions

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Is it possible to do without wearing glasses for astigmatism?

Various methods of physical, optical and functional effects are used to correct childhood astigmatism.Correctly fitted glasses are one of the most important ingredients in preventing the development of amblyopia (“lazy eye”) with astigmatism. The goggles can be prescribed to be worn permanently or only to perform some kind of exercise at close range. The doctor necessarily evaluates the patient’s tolerance of spectacle correction. If necessary, contact lenses can be fitted to the child.

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What does the diagnosis “complex astigmatism” mean?

Complex astigmatism is the presence in both main meridians of refractive errors of the same nature (myopia or hyperopia), but of varying degrees.

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If myopia is complicated by astigmatism – can it be corrected?

Cases when astigmatism accompanies myopia, unfortunately, occurs in many patients. Therefore, cylindrical lenses for correcting astigmatism are often combined with lenses for correcting myopia.Making such complex glasses is difficult, and it is no secret to anyone that this is a temporary measure. To date, the most effective method for correcting astigmatism with myopia is excimer laser vision correction. During this procedure, vision is corrected by changing the shape of the cornea. Laser correction eliminates astigmatism up to ± 6.0D and is performed on an outpatient basis, in the “one day” mode. The depth of exposure is strictly limited – no more than 130-180 microns. It is safe to say about the accuracy and safety of this method of treating astigmatism.

Clinic licenses

Removal of a foreign body from the eye

The ingress of a foreign body into the eye occurs quite often. This type of injury is the most common type of eye injury. Most often, metal scale gets into the eye when working with a grinder or during welding, or small foreign bodies (specks, eyelashes, etc.)that can get into the eye in strong winds or without any external influences on the eye.

The main complaint is pain, foreign body sensation, lacrimation, photophobia. As a rule, it is impossible to remove a foreign body on your own, so it is best to seek help from an ophthalmologist. When a metal scale enters the eye, it sticks to the front surface of the eye – the cornea. The doctor will drip anesthetic drops and remove the foreign body with a special microsurgical instrument on an outpatient basis.After removal, a wound (erosion) forms on the cornea, which also gives the patient a slight sensation of a foreign body, and photophobia may persist. Therefore, after removal, it is necessary to instill drops into the eye for some time and lay an eye ointment. The treatment and its duration are determined by the doctor.

Sometimes small foreign bodies, getting into the eye, end up under the upper eyelid. In such cases, it is also very difficult to remove this foreign body on your own. Rinsing the eye with water does not always work.Only a doctor can remove such a foreign body by twisting the upper eyelid. This is a simple procedure, quick and painless. After it, the patient immediately feels relief from symptoms.

There are also more serious eye injuries, in which a foreign body enters the eyeball, breaking through its shell. Such injuries require urgent hospitalization of the patient and immediate removal of the foreign body by surgery in a hospital setting.

If a foreign body gets into the eye and within a few minutes it was not possible to get rid of it on your own, you should immediately consult a doctor.Long-term presence of a foreign body in the eye (especially metal scale on the cornea) can cause inflammatory diseases of the eye of varying severity, requiring long-term treatment, sometimes in a hospital setting.

90,000 Eyes used to see: COVID-19 can provoke retinal pathologies | Articles

Coronavirus can infect the blood vessels of the eyes, causing damage to the retina, the Department of Ophthalmology of the Federal State Budgetary Institution NMITsO FMBA of Russia told Izvestia. Thrombosis of retinal veins and arteries is manifested by a decrease in vision.Also, those who have recovered have symptoms such as spasms of the eye muscles and inflammation of the optic nerve, experts said. The danger of infection for eyes is also confirmed by international studies. In particular, scientists from the PRC reported that they found SARS-CoV-2 viral RNA in part of the retina samples of deceased patients with COVID-19.

Strikes in the eyes

Scientists from the Stem Cells and Retinal Regeneration Laboratory of the Eye Hospital of Wenzhou Medical University in China have published a review that summarized all the available material on eye diseases caused by coronavirus.The authors pointed out the key role of two receptors through which SARS-CoV-2 can affect the visual system.

“Aerosols infected with the virus enter the surface of the eye and can later enter the respiratory system through the nasolacrimal system. The receptor ACE2 (the main gateway to human cells – Izvestia), which is also expressed in the retina, acts as a mediator for the penetration of the virus into host cells, ”the text of the article says. From this, the authors concluded that SARS-CoV-2 may harm the retina.

The second receptor through which the virus enters the eye is CD147. This is a protein from the immunoglobulin family, which, among other things, triggers the work of metalloproteinases – proteins that rebuild the extracellular substance in tissues. SARS-CoV-2 can bind to a receptor on the surface of cells. In the eyes, it is expressed on the surface of rod-cone cells.

Photo: Izvestia / Dmitry Korotaev

SARS-CoV-2 viral RNA was also found in part of the retinas of deceased patients with COVID-19.Scientists have concluded that the coronavirus can spread through tears and aerosols. Therefore, more research is needed on eye diseases caused by infection, the authors of the work believe.

COVID -19 can cause disorders of the visual system, the head of the ophthalmology department of the Federal State Budgetary Institution NMITsO FMBA of Russia, a full member of the European Society of Cataract and Refractive Surgeons (ESCRS), a member of the Russian Society of Ophthalmologists Nika Takhchidi confirmed to Izvestia.We are talking about lesions of the ocular surface (conjunctivitis), changes in the retina, inflammation and thrombosis of the vessels of the eyes.

– Coronavirus can affect the vessels of the eyes, causing microvascular damage to the retina. They are manifested as follows: inflammation of the type of vasculitis and a state of hypercoagulability (disseminated intravascular coagulation syndrome). Inflammation is most often manifested by opacities in the vitreous body, changes in the retina. Thrombosis of retinal veins and arteries is manifested by a decrease in vision, sometimes by a change in the field of vision, the expert explained.

How reversible these disorders are depends on the severity of the disease, the individual characteristics of the organism, the timeliness of the visit to the doctor, Nika Takhchidi said.

Obvious problem

Today there are more than 150 types of viruses that can cause eye diseases. This includes the herpes virus, adenoviruses, cytomegalovirus, rubella, measles, chickenpox, mononucleosis. Both adults and children are susceptible to such pathogens. As a result of infection, blepharitis, conjunctivitis, keratitis, uveitis, chorioretinitis can occur.Possible damage to the conjunctiva, cornea, choroid and retina.

– The new coronavirus infection also affects the immune system, causing autoimmune reactions in many organs and tissues, including the eyes. Cases of autoimmune retinal vasculitis have already been described, ”Yekaterina Markova, an ophthalmologist at SM-Clinic, told Izvestia.

Photo: RIA Novosti / Evgeny Odinokov

According to her, some patients notice a decrease in vision, having had a coronavirus infection for quite some time.Also, worsening is reported by those who have suffered from COVID-19 with the initial stage of cataracts. Ophthalmological examination confirmed: lens opacities progressed.

Due to vascular lesions, a frequent complication can be deterioration of vision by several units at once, Maria Petina, deputy chief physician of the Medsi Clinical Diagnostic Center, told Izvestia. Therefore, it is important to prescribe therapy on time, she added.

– To understand the cause of decreased vision and identify possible microthrombi, the doctor prescribes a tomography of the fundus, – said the expert.- Damage to the organs of vision, spasms of the eye muscles, disturbances in the functioning of the optic nerve and inflammation of the retina, the World Health Organization has already recorded among the frequent symptoms of COVID-19. Today there are studies claiming that the eyes are the “entrance” gate for the virus into our body and they are primarily affected.

The situation is aggravated by the fact that the pH (a measure of acidity – Izvestia) of the SARS-CoV-2 coronavirus coincides with the pH of a human tear, Maria Petina noted. Therefore, the virus, once it gets on the mucous membrane of the eyes, lingers there.

– Feels like the eyes begin to “melt”. This happens, for example, with herpes, – said the specialist.

To protect the eyes, doctors recommend to be outdoors more often and to observe safety measures: wear not only masks and gloves, but also goggles, and also not touch your eyes with dirty hands. In case of complaints of decreased vision, the appearance of spots before the eyes, distortion of lines, narrowing of the visual fields, you should immediately consult a doctor.

Why can there be pain in the eyes?

Cutting in the eyes is a rather unpleasant symptom, the causes of which are varied.Let’s figure out what can provoke pain in the eyes, and how you can get rid of this feeling. The reasons may be as follows:

1. Inflammatory processes of the eyeball – conjunctivitis, keratitis; eyelid – blepharitis, uveitis (with these diseases, in addition to pain in the eyes, there is lacrimation and photophobia). The infection gets on the mucous membrane of the eyes with its microtrauma, non-observance of hygiene rules during the use of contact lenses, as well as when lenses are worn out longer than the prescribed period.
2. Viral infections: herpes, adenovirus, measles.
3. “Dry eye syndrome” is a disease in which the natural hydration of the mucous membrane of the eyes is impaired. The reason for this can be eye strain, for example, when working at a computer, as well as excessively dry air in the room due to air conditioners or heaters.
4. Neurological problems such as trigeminal neurology.

To get rid of the pain in the eyes, you need to visit an ophthalmologist to establish the exact cause of this discomfort.The doctor will conduct an examination, take a swab from the surface of the eyes and scraping from the eyelids for analysis, assess the level of tear formation.

Antiviral drops will be prescribed after test results are obtained and inflammatory or viral infections are detected. For dry eye syndrome, artificial tear preparations are effective.

To avoid such eye diseases, certain rules must be followed:

• Always remove and wear contact lenses with clean hands only;
• clean and store lenses in a multifunctional solution, change the lens container at least every three months;
• when swimming in the pool, use special glasses;
• if you swim in contact lenses, then it is better to choose one-day ones for this, so that afterwards you can immediately replace them with a new pair;
• when you are doing work in the course of which there is a risk of injury to the eye, then use special protective glasses.

Protect your eyes and do not delay visiting an ophthalmologist!

90,000 The most dangerous eye injuries happen at the dacha when chopping firewood – Rossiyskaya Gazeta

Yesterday the head of the Konovalov Ophthalmological Center, Professor Mikhail Konovalov, was a guest of RG. Mikhail Yegorovich came to the editorial office after having performed eight operations in his clinic. And it so happened that it was on this day that colleagues from Germany, Ukraine, Sochi visited the clinic.Sanctions are sanctions, and doctors from different countries communicate, learn from each other’s experience. The address of the Konovalov clinic was not chosen by chance: everything here is at the most modern level, there is something and someone to learn from.

But the conversation in the editorial office began with … the summer cottage season.

Mikhail Yegorovich, the townspeople are now leaving for their dachas. And, we know, involuntary “victims” of various works on the ground have already appeared in the clinic. How to open and spend the summer season without harm to the eyes?

Mikhail Konovalov: Most of us are summer residents.For a period of time, we become people who are engaged in agriculture. Including me.

With such and such hands?

Mikhail Konovalov: Yes. Although physical labor does not have a very beneficial effect on the hands of a microsurgeon, if everything is dosed, then it is not scary.

Do you work with gloves?

Mikhail Konovalov: Mandatory. But if we talk about the eyes, then any injury is dangerous for them. The first injury is simply the ingress of dust, earth into the conjunctival cavity.This can cause commonplace conjunctivitis, that is, inflammation of the outer membrane of the eye, the conjunctiva. The eye will turn red, there will be a feeling of a foreign body, lacrimation. Therefore, in the country there should be a banal set of drops. The simplest ones are our Russian ones, albucid. That is, if it is conjunctivitis, or a foreign object has entered the conjunctival cavity, then you need to drip more of these drops.

How much is more?

Mikhail Konovalov: 2-5 or even 10 drops.And, in general, this is where it all ends. The second option: if, for example, a grain of sand or sand particles gets into the eye. They can damage the cornea. As a rule, the outer layer of the cornea called the epithelium is affected. The cornea is a very sensitive tissue. If even a fraction of a millimeter of its area is exposed, then the symptoms are already stronger: in addition to lacrimation, photophobia, unwillingness to open this eye. This is the so-called corneal erosion. Here the treatment is different.

The first thing to do is drip disinfectant drops or antibiotics.The fact is that a bare surface is like tearing off a piece of skin on the body. Accordingly, the infection can join more easily. Therefore, you need to instill antibiotics and drugs that improve tissue regeneration. That is, healing. There are many such drugs, ranging from artificial tears, drops and ending with solcoseryl. These are more viscous preparations and are sold in tubes. And, as a rule, they help.

Are these antibiotics available over the counter?

Mikhail Konovalov: Yes.The third option: when we cut or chop off branches, and their derivative enters the eye cavity. Blunt trauma occurs. As a rule, this ends again with erosion. And the treatment is about the same. We must remember: if there is serious work ahead – chopping wood, hammering nails, manipulating a sledgehammer, then you need to wear special goggles. Because the most dangerous injuries occur when a small particle of an iron object flies off. It flies very fast, it is very sharp and easily pierces the eye.

The most dangerous eye injuries occur in the country when chopping wood or working with metal, when small fragments fly off

Depending on the impact and hit, localization, the splinter can get stuck in the sclera – the white part of the eye, which is quite dense. This is the best variant. It can also get stuck in the cornea – it’s also not scary: it can be removed from there. But if it flies further, then this is a penetrating wound. The integrity of the eye is impaired. And if the impact is very strong, then the particle flies into the cavity of the vitreous body up to the retina.

Trivial injuries are usually easy to heal. Even if a splinter hits the cornea. The patient comes to the doctor’s appointment. The doctor drips anesthetic drops, and with an ordinary injection needle, this splinter is removed under a slit lamp.

But is it necessary to see a doctor in this case?

Mikhail Konovalov: Of course. In addition, when people are sawing metal, hot pieces of metal are thrown off. A typical injury is possible: a splinter enters the cornea and a small burn forms around it.It can be removed with an injection needle. And this is where it all ends. But again, dripping drops, antibiotics are necessary. In any case, everyone should remember about safety.