Don't Let Daily Life Rob You of Vision
Just this week, I examined a 16-year-old female who had been struck in the eye by a tennis ball glancing off the edge of her racket. When I asked her if she had been wearing any type of sports goggle or other protective eye wear, she said ‘no.’ Fortunately, her vision remained intact (20/20 on the eye chart) and she had few complaints, other than a sore eye and a fuzzy spot in her peripheral vision. However, when I dilated her pupils to look at the inside of each eye, I quickly discovered a hole in the retina of the traumatized eye and a rupture in the back wall of the same eye, findings that place her at increased risk for vision loss in the future. I wish I could say this was the first patient I have examined with a preventable eye injury, but the fact is that I and my colleagues see many such cases every year.
In fact, eye injuries are second only to cataracts as the most common cause of visual impairment in the United States, and sadly, the majority of these injuries are preventable with use of protective eye wear. Some studies show that nearly 1% of the population suffers an eye injury each year; with about 30% of these patients seeking emergency room treatment (about one million patients were seen in emergency rooms for eye injuries in the year 2000). Of course, sports related injuries are not the only culprit - other common causes of trauma include: abrasions of the front surface of the eye (e.g. inadvertent fingernails from an infant or other ’playmate’); household foreign bodies lodged in the eye (e.g. splinters, metal shavings, paint chips etc.); chemical, electric and thermal burns (e.g. from household cleaners to battery acid to cigarette butts to curling irons); physical assault (fists, elbows, daggers, bullets etc.); motor vehicle accidents; work related injuries.
Most eye injuries occur in the home (over 40%), but many also occur at work and other public places. In general, children are more likely than adults to be injured, but the highest risk is for adults between the ages of 20 and 30, with males having a higher risk presumably due to a higher likelihood of engaging in riskier physical activities.
Damage caused by a severe eye injury can lead to a number of serious eye diseases, including cataract, glaucoma, retinal detachment, and late-stage bleeding due to growth of abnormal blood vessels through ‘cracks’ in the back wall of the eye (known as a ‘choroidal rupture’ – what the patient described above suffered). Fortunately, many of these serious conditions can be treated, and most injuries result in less serious, self-limiting problems like traumatic corneal abrasion or iritis, which, while painful, typically resolve very well. Unfortunately, most people fail to take the simple but necessary steps to avoid both the less serious and potentially blinding effects of an eye injury.
When it comes to eye injury, the best offense is a good defense. Always wear protective eye wear with durable frames and impact-resistant polycarbonate lenses whenever participating in any activity where a flying object, aerosol or liquid might directly strike the eyes: mowing the lawn; weed whacking; using any household or industrial chemicals or cleaners; playing any sport using a ball that is small enough to fit within the space between the bones of the eye socket (especially racquetball, tennis, baseball, golf, hockey) or where fingers, fingernails or elbows are likely to strike the face and eyes; and any activity involving grinding/sawing/filing/pounding/hammering on wood, metal or plastic.
Use of an appropriate face mask or safety glasses with side shields should always be considered in any industrial setting with high velocity projectiles or dangerous chemicals. Always use seat and shoulder belts (as well as appropriate infant and car seats) when driving; eye injuries are common in automobile accidents, even at slow speeds. For those of us using hypodermic needles to inject or pump insulin (or ByettaTM or SymlinTM), always keep the sharp end pointed away from the face (I saw a patient several years ago who accidentally punctured her eye with an insulin syringe when attempting to recap it!) Finally, if you already have visual impairment as a result of eye disease, injury, or amblyopia (‘lazy eye’), always wear protective eye wear to guard your better seeing eye and be particularly cautious about participating in hazardous activities. When it comes to eye injury, an ounce of prevention is definitely worth a pound of cure.
For more information on diabetic eye disease, consult Dr. Chous’ book Diabetic Eye Disease: Lessons From a Diabetic Eye Doctor, Fairwood Press, Seattle, 2003.
Read more about Dr. Chous here.
Visit Dr. Chous' website here.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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