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August 14, 2010 9:46 PM   Subscribe

Eye injury? ER now, urgent care tomorrow, regular doc Monday, or relax-it'll-be-fine?

About an hour ago my eye started hurting. Then it started REALLY hurting. I took out my contacts and it looks like there's a chip missing--scooped out, like--from the surface of the eye (head-of-pin sized). Boy, this hurts. I mean, this really hurts. But my pain tolerance took a nose dive last year, and I'm still not used to it; I can't gauge pain anymore.

How bad is this? Is this ER right now bad?

Or urgent care tomorrow (Sunday)?

Or regular doc on Monday?

Or just let it go, eyes are resilient and it'll heal, if it's not better in 48 hrs check again?

Bonus question: will this affect my appointment on Monday to be examined for convergence impairment?
posted by galadriel to Health & Fitness (18 answers total) 1 user marked this as a favorite
Best answer: Get to the hospital RIGHT NOW. NOW NOW NOW.

You probably have a corneal ulcer. I've had them twice. Your description sounds exactly like the situation i had. IT'S AN EMERGENCY. Like, a "there's 12 people who've been waiting for 3 hours but you get to go next" kind of emergency.
posted by Kololo at 9:53 PM on August 14, 2010 [7 favorites]

Best answer: It would help to know the nature of the injury; everything in the eye hurts like hell, but still go to urgent care right now (if your insurance will cover it, the ER if it won't.) Eyes aren't resilient in my experience, they are well protected but, once an injury happens, it is important to take care of it.
posted by Some1 at 9:54 PM on August 14, 2010

Best answer: I wouldn't take chances: go to the ER.
posted by StrikeTheViol at 9:56 PM on August 14, 2010

Response by poster: K. Thanks. Going.
posted by galadriel at 9:58 PM on August 14, 2010

Best answer: Yes, if you have the means, go to the ER right now.
posted by triceryclops at 9:59 PM on August 14, 2010

Best answer: Corneal ulcer or corneal laceration, needs treatment ASAP. Expect eyedrops and bright lights, but remain optimistic.

(Got a small chunk taken out of my cornea once, under the best possible circumstances-- in the doc's office. I am fine, but obviously I got the fastest possible treatment.)
posted by fairytale of los angeles at 10:02 PM on August 14, 2010

Best answer: Also, yes, corneas hurt like fuck. That's not just you.

You should keep your convergence appointment regardless; even if they can't do the testing, which I suspect they still can, it'll be good to get a second set of experienced eyes on that scrape.
posted by fairytale of los angeles at 10:04 PM on August 14, 2010

Best answer: Corneal injuries suck. Even a simple corneal abrasion will hurt like a mofo and make you want to claw your eyes out.

Let us know how the visit went.
posted by azpenguin at 11:59 PM on August 14, 2010

Best answer: IANAD but I HACA (had a corneal abrasion). After it's healed, you should be told that you're likely to develop Recurrent Corneal Erosion Syndrome, which is where your eyelid keeps tearing the scar off every few weeks. You have to put ointment in nightly for, like, a month. Do it! No fun to keep going back.
posted by cogat at 4:14 AM on August 15, 2010

Best answer: Please come back when you can and let us know you're okay.
posted by Evangeline at 4:16 AM on August 15, 2010

Best answer: Oh and another thing: the first doc I saw (at an an eye hospital no less) gave me antibiotics and told me it would heal by itself. It got worse the next day, and I went to another guy who did 3 things:

1) Put in a 'bandage' contact lens, to keep your eyelid/tears from washing away the new cells
2) Gave me homatropine drops, which dilates your iris and helps stop it from moving (and thus causing pain)
3) Bagged out the first guy for having no idea how to treat corneal ulcers.

Good luck!
posted by cogat at 4:18 AM on August 15, 2010 [1 favorite]

Best answer: I hope you are okay. I got a gouge taken out of my eye by my toddler's fingernail just this week. I called the local triage line (it was after hours), and the nurse said to head to the ER. After many bright lights and numbing eye drops, I got antibiotic eye drops, painkillers, and a tetanus shot, because apparently you can get tetanus via the eye, which makes me shiver just thinking about it. One of those things that with treatment is no big deal, but without treatment is like the worst thing ever!

(It was a corneal abrasion and did get mostly better after 48 hours ... it's been 4 days and just feels kind-of itchy now, mostly -- the doctor said eye injuries hurt like a mofo but usually heal fast. She was right!)
posted by Eyebrows McGee at 5:25 AM on August 15, 2010

Response by poster: Thanks folks! It turns out I have an inexplicably perfectly circular corneal abrasion.

Boy, that was intensely painful. I started crashing hard when they put the numbing drops in. Well, it was 3am, too. But the relief from the "something is EATING my EYE" pain was soooo nice. Oh yes. I had trouble staying conscious until we got home.

I can't wear my contacts until the symptoms are gone; I can't get the convergence testing done without my contacts, I think. And I'd really rather not make hubby take a day off work AND do the 2hr drive to the specialist if we can't get the test done properly :( I'll see if I can find someone local to take another look at my eye tomorrow, I guess.

I wonder if I can swim today. I wasn't coherent enough to ask last night.
posted by galadriel at 7:43 AM on August 15, 2010

Best answer: Don't go swimming today. If the abrasion isn't healed, your eye may get infected, now or later on. You should see an eye doctor (it wasn't clear whether they had one where you went) if your insurance allows it, and they may even send you to a cornea specialist.

A couple weeks ago I had a nasty eye infection due to an ulcer in my cornea that resulted in 5 visits to the eye doctor and one to a cornea specialist. With some antibiotic drops most of the pain went away in a few days, and I'll be taking steroid drops for another 10 days.

Good luck and hope you get better quick!
posted by adahn at 8:14 AM on August 15, 2010

Best answer: Glad to hear you are ok. My wife had one of those a few years back, and I do recall instructions to stay away from swimming for a few days. She was training for a triathlon at the time, so I recall her disappointment.

I also recall the pain. I wasn't the best husband at first. Mrs. Centerweight can be dramatic when injured, and I come from a family of "it's just a flesh wound" stoics. So when she started rocking back and forth and whimpering in the ER waiting room - a waiting room that also featured a carpenter who cut off a finger and a gang member with a stab wound, both of whom were quite calm and collected - I acted a bit less sympathetic than I might have.

Big mistake. The triage nurse said a corneal abrasion is often rated as an 8 or 9 on the pain scale. Behind some cancers, major organ failure, torture and the fracture of really big bones. All from falling asleep in her contacts.
posted by centerweight at 9:30 AM on August 15, 2010 [1 favorite]

Best answer: i am so glad to hear you went to the hospital and got some attention! The real risk with corneal injuries is infection - which can either cause serious problems with your vision, or can cause problems with scarring/healing. So avoid anything that could cause an infection (like swimming).

And yeah, the pain is terrible! I once had a conversation with someone else who'd also had a corneal ulcer, and i said "I have a feeling i'm never going to experience anything that painful again until i give birth", and she said "i've experienced both, and yup - the pain is about the same."

Oh, and far as collapsing from exhaustion after they gave you drops, i did the same thing, but it was the middle of the day. I ended up sleeping in recovery room off on and on for 3 hours - i couldn't even bring myself to get out of the clinic and into the car.
posted by Kololo at 7:50 PM on August 15, 2010

Response by poster: Well, whaddaya know. I saw the optometrist this morning and she says it is clearly a corneal ulcer. Even if they missed it when they stained it and checked under black light (although she says it's very visible, even after a day and a half of healing), she says the fact that the spot was white is the obvious giveaway.

But the eyedrops they gave me were appropriate, which is good. She says in a couple of days, when the surface is closed over, she'll want to change what I'm doing in order to minimize scarring (which was the point where I freaked out a little, but she said it's far enough away from the pupil that it won't affect my vision even if it leaves some scarring).

posted by galadriel at 10:08 AM on August 16, 2010

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