Monday, October 7, 2013

Medical Mondays: Ow, my eye!

Hi guys!

Leslie Rose emailed this question:

If someone was impaled in the eye by a something about the consistency of a stiff palm frond what kind of damage would there be to:

A) Cause bleeding
B) Impair sight

Great question. I'm not an ophthalmologist, so I'll do my best with this answer. 

Obviously, the idea of a stiff, razor-sharp, pointy palm frond in the eyeball would make anyone shiver (and maybe gag. Just a little.) So get the gagging over with, and let's see what we can do for this poor character!

When the wall of the eyeball is broken through from trauma, it is called an open globe injury. This case would be called more specifically an open globe laceration, and often accompanies an intraocular foreign body (fancy term for some thing from the trauma left over inside the eye). I didn't include a picture, but you could probably imagine the coffee-spewings that might occur if I did. And I don't want to pay for anyone's broken laptop so...if you're brave, Google "open globe laceration." But let the Googler beware.  ;)

So. Would it bleed?
Yes, but the eyeball wouldn't necessarily be dripping blood. The white of the eye (the sclera) would likely be very reddened from irritation and bleeding would occur around the area of the wound beneath the thin membrane (conjunctiva) that covers the sclera (called a subconjuctival hemorrhage.) 

Would it impair sight? Depends. 
Most penetrating globe injuries include trauma to the cornea (the clear covering over the iris, or colored part, of your eye). The vision right after the injury helps predict whether the vision will stay bad. For example, if the vision is still decent and medical help is sought immediately, it's in the character's favor that they'll keep good vision in the eye.

But, if vision is really poor after the injury (can barely read anything on an eye chart, or can barely see a hand waving in front of their face, or differentiate between light and dark), that's a poor prognosis.

Other signs of a bad outcome are:
  • character can't be seen by an ophthalmologist and have surgery (if necessary) within 24 hours.
  • residual palm frond is stuck in the eye, causing infection (endophthalmitis
  • other injuries, like a eyelid laceration, detached retina, broken eye socket bone
  • blunt trauma to the eye
  • if the vitreous got extruded from the eye. (That's the fancy way to say "eyeball jelly spurting out." Sorry, guys.)
There you go Leslie! So basically, her character's vision in that eye would depend on how severe the injury was, and how quickly they could seek modern medical help with an ophthalmologist.

(Just an aside, let me tell you how happy I was when I finally figured out how to spell OPHTHALMOLOGIST correctly in med school. So proud. Look at how many H's there are in that word! And that wonky LM!)

I'm sure your eyes are watering. Keep them away from palm fronds, okay?


Old Kitty said...

Ow, ow, ow!! My eyes are watering just reading this!! Yikes! Yes, wear wrap around glasses and keep away from such objects! :-) Take care

Natalie Aguirre said...

This one did make me almost gag. Sadly my dad's eye was poked with a stick holding up a window when he was young and he lost his eye sight in that eye. So it can be very serious.

SA Larsenッ said...

Took me a few to get over that gagging. Something about the phrase 'open globe' referencing the eye makes me go Eewwwww!

Dianne K. Salerni said...

Ahhh .... I had to just skim over this. But Lydia, you were brave and professional to tackle the question!

Shelly said...

I realized at the end of your post I hadn't taken a breath and I had to unclench my hands to type this comment. Ack!!! That would indeed be an item of interest to add to a plot line~

Em-Musing said...

Everytime I water my plants, I realize if I'm not careful, I could get my eye poked by their frond, limbs, whatever. After reading your blog, I may just wear safety glasses.

Karen Lange said...

Ow, this makes my eyes water just reading it. And this is why I don't live near any palm trees. :) Thanks for the info!

Barbara Watson said...

My daughter plays basketball -- change palm frond to finger, sometimes with fingernails. So it's awesome our eyes close so quickly. :-)

Connie Keller said...

I had the edge of a spring-shut locker door catch my eye--it slipped from a friend's grasp. Boy, did that hurt. My vision in that eye clouded, but my sight came back.

Alex J. Cavanaugh said...

More than I've ever needed to know.
The eyeball might not bleed, but get hit with something solid around the eye, like on the eyebrow, and it's blood-gush galore. (Yes, I speak from experience...)

mooderino said...

That was an uncomfortable read. I always hate scenes like this in horror movies.


Southpaw said...

EWWWWW, eyeball jelly! Would there be any significant problems if the character wore contact lenses? Or do they just be pulled out with the plant?

Anonymous said...

You have such a way with these icky topics! I want to say eww and lol at the same time.


J E Oneil said...

Ick. Just ick. Good information to have, but ick.

I thinkwhat's annoying about "ophthalmologist" is that it has h-t-h right in a row. It just looks wrong.

Catherine Stine said...

Ouch, just the thought makes me cringe. I am quite protective of my eyes because I couldn't bear an eye injury. Interesting medical details, though!

Jessie Humphries said...

I like the sound of a detached retina as a result of palm thrust! Might have to steal that ;) As usual, awesome medical insight, Lydia.

Jay Noel said...

I work in the industry, and doctors say the most common eye injury they see is a tree branch or finger nail scratching the cornea.

LD Masterson said...

Two thoughts - I know how to spell ophthalmologist (but I don't know why)and I've definitely not brave enough to Google "open globe laceration".

Mark Koopmans said...

In Ireland they say something bad is never "as bad as a sharp stick in the eye" and now I understand why :)

Leslie S. Rose said...

I'm so embarrassed to be this late to my own question. Oops. I should use the excuse that I got poked in the eye and couldn't see my monitor! Can't wait to embellish my character's torture with this juicy - or should I say, vitreous information. Thanks, Lydia.

Eva Inka Nurmaisya said...

Banned complain !! Complaining only causes life and mind become more severe. Enjoy the rhythm of the problems faced. No matter ga life, not a problem not learn, so enjoy it :)

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