EYE DISORDERS - Medicine for Mountaineering and Other Wilderness Activities - page 197

likely, and the infection can quickly extend inside and to the back of the eye, resulting in
an ocular emergency.
Steroids must not be administered because they increase the susceptibility to infection.
Antibiotic drops and antibiotic ointment should be administered to prevent infection. If
possible, the eyes should be kept closed; a bandage over the closed lids can help. A top-
ical anesthetic relieves the pain but makes it more likely that the person does not keep the
eyesclosed,whichallowsgermstoreachthecompromisedsurfaceofthecornea.Atopical
anesthetic must be used with great caution and only when required to safely evacuate the
individual.
Foreign Bodies and Corneal Abrasion
Foreign bodies and corneal abrasions can also be significant sources of ocular surface
damage.Bothcanoccurinvirtuallyanyoutdooractivity.Bothtypicallycausesevereirrita-
tion,tearing,andrednessoftheeye.Commonforeignbodiesincludedirt,debris,andother
particulate matter that reaches the surface of the eye.
If the foreign body remains very superficial, then tears often wash it out. If tears do not
remove it, sometimes the foreign body can be washed out intentionally, ideally with arti-
ficial tears. Occasionally a foreign body may become embedded deeper in the cornea in
which case the person usually needs an ophthalmologist to remove it under a slit lamp.
Foreign bodies can also become lodged on the inner, conjunctival surface of an eyelid.
As the eyelid blinks, the body rubs across the surface of the cornea, leaving corneal
scratches.Theeyelidshouldbeeverted,andtheforeignbodyremovedwithamoistcotton-
tip applicator ( Fig. 15-2 ). The applicator should not be used on the cornea itself, as it may
result in a larger defect. Besides scratches from foreign bodies, painful corneal abrasions
that lead to flooding of tears that blur the vision can also occur from inadvertent trauma,
such as a fingernail or tree branch scratch.