Recent Observations On Eye Injury and Eye Protection
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BY A DOCTOR
A30-YEAR-OLD service station attendant had an unpleasant, though by no means unique, experience. Concentrated ethylene glycol that was being poured into a radiator splashed into his left eye. A few days of treatment were of no avail, the eye became progressively worse and he complained of poor vision.
The doctor who reported on this case described a swelling of both lids of the left eye when he saw the patient. The conjunctiva—the delicate membrane that lines the eyelids and covers the white of the eye—was heavily inflamed; the pupil was constricted, it reacted sluggishly to light and vision in the left eye was noticeably decreased.
Under the biomicroscope, several small, superficial, pinpoint areas of the cornea were seen to be injured. There were other changes, too, in parts of the left eve. Hot compresses and atropine drops were used. In one month the eye became clear, and no lasting defects remained from the accident.
The label on the ethylene glycol container described it as concentrated, with "no glycerine, ethyl or denatured alcohol or methanol, wood, or synthetic methyl ". The toxic properties of ethylene glycol are feeble, but heavy enough to produce a bad chemical injury of the eye.
Chemical Burns Chemical burns of the eye and injuries from acids and caustics require expert medical treatment. However, first aid is of vital importance. The preservation of sight may depend upon the immediate administration of a simple remedy. There is no time to wait for the arrival of the doctor in such cases; a man's sight may depend on the proper first aid given by a supervisor or fellow worker.
The simple remedy for this kind of injury is: plenty of clean water. This is more important than the use of an appropriate neutralizing agent. If acids or caustics fall on the eyes, immediate washing with clean water is essential, for their action is most rapid and may cause blindness. The exception is a burn with quicklime, where water will increase the injury. Particles of quicklime or caustic lime getting into the eye should be picked off at the earliest possible moment in order to stop the production of harmful lime water. •
A usual practice, according to a specialist. is to keep bottles of distilled water handy with which the injured eye can be washed out at once. Other methods are syringing out the eye with sterile water or directing a small jet of water into the eye from a small. flexible hose. Very helpful is plunging the head into a vessel of clean water and winking the eyes rapidly, or to use the water from a bubbler drinking fountain to irrigate the eyes.
Counteracting Solutions At one time, counteracting solutions were advocated for first aid. For instance, a saturated solution of bicarbonate of soda for acid burns, or a 2 per cent solution of acetic acid for alkali burns. Modern practice, however, relies on plenty of clean water. If neutralizing reagents arc used at all, they should be applied only under medical direction.
Inflammation of the conjunctiva (conjunctivitis) i.s a frequent occurrence. it may result when grit or dust irritate the eye, or it may be produced by intense light or glare of the sun.
The first thing noticed is itching and burning and an unpleasant sensation of grit under the eyelids. A sticky secretion is poured out from the conjunctiva. In the morning, the edges of the eyelids and eyelashes are glued together, and this is a most typical sign. The eye may become painful and tearful and exposure to the bright light of the open air or a bright, artificial light causes acute discomfort.
Cold compresses may relieve the painful sensation until local treatment is started by the doctor. A shade and dark glasses protect the eye if light is hurtful.
Arc Flash Arc flash, usually a conjunctivitis of both eyes, is caused by excessive exposure to a welder's electric arc. Vehicle repair and garage mechanics often haVe to use welding in their job. Arc flash is characterized by delayed onset, duration of 24 hours, red eyes, swelling of the lids, slight sunburn of the face, production of tears, intolerance to light and a feeling of sand in the eyes.
With proper care all these signs disappear in most cases within 24 hours, and almost certainly within 48 hours. Eyes are protected from the infra-red rays of the arc flash by ferric oxide lenses which filter out most of the harmful radiations. To relieve the pain and other symptoms cold applications to the eyes are used. The doctor uses a local antesthetic, ephedrine, etc., in the eyes, or he gives a pain-relieving drug.
The minimum safe distance from a welder's arc without protection by goggles is estimated at 200 ft.
Most foreign bodies are superficially
located in the eye. The eyelids close automatically when anything threatens the eye. If a foreign body—sand, dust, wood, metal splinter, etc.—lodges on the eyeball, an increased flow of tears often succeeds in washing it off. The foreign body is removed at the corner of the eye.
If this is not successful, it may be possible to lift the foreign body off the eye with the clean corner of a handkerchief or a clean piece of blotting paper. In the first-aid room the eye may be irrigated with a non-irritating solution. Tears contain a disinfecting substance which will destroy a good many germs lying around in the eye.
Do Not Rub
The worst possible thing is to rub an irritated eye. Don't try to rub a foreign body off the cornea—the transparent part of the eye through which is seen the pupil, the dark hole in the middle of the eye. If the foreign body does not come off on blotting paper or such like, it is probably embedded in the cornea. Any rubbing will only implant it more deeply and make matters worse. Leave it to the doctor.
Sometimes metallic foreign bodies can be removed with the help of an electromagnet, a highly satisfying operation if it succeeds. A small chip of metal from a hammer or chisel may strike the eye at a high velocity and all that may be seen is a minute track in the cornea. A foreign body within the eyeball requires highly specialized care.
Most eye accidents are caused by flying particles set in motion by hand tools and machinery. The next common cause is abrasive wheels. It is far better to prevent such accidents than to treat them.
Improper attempts to remove a foreign body from the eye have sometimes seriously damaged the eyesight. Under normal conditions the surface of the eye heals with great speed.