Now, first of all you need to know that I am an animal lover and we have 4 cats, a dog, a lizard and a pet rat at our house.  Unfortunately, however, I was called in again, recently, for a little girl who was scratched in the eye by her pet cat named "The Captain"  (I supppose like in Captain and Tenille.)  She is such a fortunate kid because the scratch from the cat claw just created a small scar in the more superficial layers of the cornea. It appears that it will have no long term effect.  I saw a lady last year where the cat claw actually caught hold of the conjunctiva and I actually had to suture the conjunctiva in the operating room.  Another complete recovery, thankfully.  I was quite concerned about the possibility of infection in both cases, but the antibiotic drops prevented that.

All this brings to mind other animal related eye injuries that I have seen over the years.  The worst have been dog bits and for some reason, dogs seem to have a preference of going for the face.  The funny thing is that it's not always the big Rotweillers, Pit Bulls and Dobermans you would suspect, but sometimes Shih Tzus and Jack Russells or other energetic little dogs.  Our middle child Ashleigh, was actually bitten in the face (very minor injury) by a nearly blind Jack Russell while playing at the beach.  Thank God I have never seen any snake bites, lizard bites, bat bats or otter bites (even though a man was just attacked by a rabid otter in Venice, Florida last week.)

Did you know that people who have pet tarantulas can develop severe eye irritation from the little spider hairs getting into the eye.  It's a well known situation described in multiple medical journals, so tarantula lovers, keep those furry friends far away from your eyes.  Definitely not a problem for me.  And if you are tempted to play with a Walking Stick bug, beware, since these mild looking, but potentially angry little guys, can shoot an extremely irritating substance into your eyes.

I guess, the take home message is to just be careful and use common sense around pets, animals and insects.  It's one thing to get scratched on the arm but quite another situation if it happens to one of your eyes.

My kids love to watch the Nickelodeon Channel show ICarly but I was appalled to see characters on the show Spencer and Sam pelting each between the eyes at point blank range with paintball blowguns.  I have treated horrible injuries to kids from regular paintball guns but my research shows that these new paintball blowguns are just as potent.  They are fairly silent and perfect for hitting unsuspecting victims.  The paintballs can reach velocity of 450 feet per second and have a range of up to 150 yards.  The longer the barrel, the higher the velocity.  Please take my advice and use these type of blowguns with extreme caution and always require 100% of the time that all participants and bystanders use proper ANSI approved eye protection.  Trust me I have seen the devestation that paintballs and arisoft pellets can do eyes.  It is a very sad situation to tell a young kid and the parents that an eye is permanantly disfugured and blind.

In the meantime I will be writing the producers of the ICarly show and asking them to at least show viewers how to wear proper eye protection.

Michael Kutryb, MD

After dealing very personally with over 10,000 cataract surgeries, I've seen just about all the things that patients can do right and wrong.  Every surgeron, like myself, has an organized, written list of instructions for you to take home after surgery.  But, of course, even the "best laid plans of mice and men often go awry."  Here is my list of helpful post-operative tips after cataract surgery:

1.  Get to know your drops and what they are for.  Typically there is a steroid (anti-inflammatory), an antibiotic, and sometimes a non-steroidal anti-inflammatory.  The more attention you pay to the names and dosages, the less likely you will be to make major mistakes.

2.  Make surey your drops are "fresh" and not an old bottle you had in your drawer for who knows how long.  Usually patients get brand new drops for the surgery, but particularly with cataract patients with glaucoma, they may not think to start a brand new bottle of glaucoma drops after surgery.  The goal here is to lessen the chances of a bottle contaminated with bacteria.

3.  Know your drug allergies WELL.  You should know what drug affected you and how.  Sometimes a person may not have a true drug allergy but perhaps had an upset stomach after taking erythromycin on an empty stomach.  That is more of a side effect than an allergy.  It is so important to know these things because incorrect allergy information can limit the choices of some pretty effective medicines.

4.  Try not to use different drops too closely together.  Keep drops of different medications at least 5 minutes apart to avoid washing out the first medication.

5.  Never touch the tip of the bottle to your eye.  First you could scratch your eye, but also you will contaminate the bottle and possibly introduce bacteria into the bottle, which could increase your risk of an infection.  If I accidentally touch the tip of a drop bottle, I usually clean it with a alcohol wipe and let it air dry.

6.  Consider taking a non-steroidal anti-inflammatory drop such as XIBROM, NEVANEC or ACUVAIL for one to two months post-operatively, even if you think you are doing great.  This class of drops can help to stabilize retinal capillaries to reduce your risk of cystoid macular edema (CME) which can cause vision loss.  CME doesn't get a lot of fanfare but it can be terribly frustrating in that a person with a perfect cataract surgery who sees 20/20 at one day or one week post-op, can have a painless and significant loss of vision at the 3 or 4 week post-op visit.  There is little downside to these type of drops other than the cost and sometimes some stinging but that are like an insurance policy against CME.  If you are a diabetic, I would definitely use these drops since the CME risk is much greater.

7.  Finally, remember that the post-operative drops are not there to soothe or lubricate the eye and they can definitely cause some degree of irriation to the surface of the cornea. Have a good supply of high quality artificial tears with a disappearing preservative like genteal or refresh tears or thera-tears or preferably some preservative free artificial tear to use 3 or 4 times a day or whenever there is irriation.  Remember to not use the tear drops right before or right after your medicated drops.  Make sure to use new, fresh artificial tears as well.

That's all for now, more to come later.  Take care.

Michael Kutryb, MD

OK, since I have this blog, I'm going to try and do my part for the public good and try to inform you about ways to protect your eyes from serious injuries.  Let's get right down to it.  I'm a firm believer in Murphy's Law.  What can go wrong, will go wrong. Always wear approved eye protection glasses (it will say ANSI APROVED) when doing any activities that you suspect might possibly put your eyes at risk.  These include drilling, hammering, trimming, cutting, spraying, weed wacking, grass cutting, fishing, using hazardous cleaners or chemicals and may other things I can't think of right now.

Here are some of the weirder eye injuries I've seen that you truly never want to experience:

1.  Superglue to the eye.  I've actually seen this 3 times and it happens because some people are nearly blind without their glasses and some superglue bottles can be similar in size to eye drop bottles.

2.  Spider guts to the eye.  In Florida, we call them Banana Spiders but they are about the size of a silver dollar and spin huge webs.  This unfortunate man had so many webs in his rafters around his barn that he decided to attack the problem with a weed-wacker and spider parts flew everywhere, including his eyes.

3.  A fisherman with a fish hook embedded into the eye.  Again, the same story. No protective eye wear.

4.  Paintball and Airsoft gun injuries to eye.  I've seen about 6 cases, all very serious, lifelong problems afterward.  All, totally preventable with proper eye protection.

5. Curling iron burns to the eye.  Also seen this about 4 times, always with women trying to curl their bangs and accidentally dropping the curling iron.

6.  A roofer nailing shingles to a roof came to see me with a nail that went directly into the eye and required 3 subsequent surgeries in order to maintain just a little vision.  He said the 2 nails had popped up and hit him in the face before the final devestating blow.  You think he might have thought to wear eye protection after the first or second time.

7. Cat claw to eye.  This cat lover, required surgery to repair the laceration, from her lovely cat that was startled and popper her in the eye.  This is the one that made me cringe the most.

8.  Exploding, bottle rocket, direct hit to the eye.  It was not another pretty sight.  We'll leave it at that.

9. Cigarette burn to the eye.  Almost always little children about the same height as a persons back pocket, which is roughly about where some smokers hold their burning cigarettes between puffs. The child can inadvertantly walk into the cigarette and get a superficial burn.  As far as I know, the few cases I have seen from emergency rooms have indeed been total accidents and all kids healed 100%.

Be careful and protect your eyes!