Eye specialist around, info needed....

[ProPlus]

My g/f went to the gp's this morning after I spotted a 'white' spot/patch on her eye (circa 1-2mm) last night, she has had an irritable eye since saturday and I had told her not to wear her contacts and wear her glasses instead, bathe the eye in saline solution and for god's sake stop rubbing the eye.

Doc said that she's got an ulcere and an abcess has formed in it so she need to get it drained and a course of antibiotics. She will need to go to LGI and they will
do it under aenestetic.

The queries I have are:

How do they do this?
How will it affect her?
How long before the abcess is gone and eye is back to normal?
What kind of things can cause this?
What can she do to stop it happening again?

Any info on the subject would be very grateful.... as its not the nicest thing in the world to find that you have an abcess and an ulcer on your eye.

Cheers,

Si

[-DeaDLocK-]

I'm no doctor, but google "Corneal Ulcer" and "Corneal Ulcers". Lots of information on the web.

[968]

ProPlus said:

My g/f went to the gp's this morning after I spotted a 'white' spot/patch on her eye (circa 1-2mm) last night, she has had an irritable eye since saturday and I had told her not to wear her contacts and wear her glasses instead, bathe the eye in saline solution and for god's sake stop rubbing the eye

If it's on her cornea, (the clear bit that covers the coloured part of the eye, where the contact lens sits on, it could be an ulcer. It night not be, sometimes at the edge of the cornea, these spots can be caused by inflammation, rather than frank infection, however in a CL wearer, one has to be safe.

ProPlus said:

Doc said that she's got an ulcere and an abcess has formed in it so she need to get it drained and a course of antibiotics. She will need to go to LGI and they will do it under aenestetic.

It might be an ulcer, but we don't drain them under anaesthetic, that bit is nonsense. If you are seen at the hospital, the eye doctor might put some anaesthetic drops in the eye, to numb it, then scrape the surface of the ulcer to try to yield some bugs to grow on agar plates, so that we can tell what bug we are dealing with.

ProPlus said:

The queries I have are: How do they do this? How will it affect her? How long before the abcess is gone and eye is back to normal? What kind of things can cause this? What can she do to stop it happening again?

As explained, they put drops in the eye, which will numb it, completely, and they will scrape a small surface area, gently with a needle or a spatula, to try to yield some bugs to grow. This is done using a slit lamp, which is the microscope we use when examining the eye, where you put your chin on a rest, and we shine a bright light onto the eye......

Once this procedure is done, we start treating with antibiotic drops, intensively, ie put them in every hour or half hour, day and night for at least 24-48 hours, before reducing. We give drops to ease pain, also.

The ulcer may take a week or so to get better, but it may take weeks after that to totally heal, and even then, contact lens wear can be dodgy. It does depend where the ulcer is, with respect to how it affects vision in the long term. If the ulcer is right in the middle, it may permanently affect the vision, a bit, if on the edge, it might not affect it at all.

If it is an infective ulcer, it is caused by contact lens wear, pure and simple. Avoiding CL wear, will prevent it from happening, but also changing brands can help. Soft lenses are more prone to infection, and I don't believe that daily disposable ones are any better. Minimising lens wear, and using cleaning products to thoroughly clean lenses, can minimise infections in future.

If you need any further advice, please email me.... I have treated hundreds of patients with ulcers, so I may be able to help you.....


Edited to add..... PS, depending on the ulcer, and the hospital, she may be admitted overnight, so that the nurses can give her drops in the eye every hour or so... not nice, but is the best way of making sure the ulcer is thoroughly soaked in antibiotics.....

>> Edited by 968 on Tuesday 20th December 11:43

[chrisgr31]

I had an ulcerated cornea a few years ago, caused they believe by the Herpes Simplex virus, and the treatment was the same stuff used for coldsores (in a different form obviously!).

I have never known anything so painful, at the time I was travelling by public transport as I had no car. On my way to the bus stop I actually walked into a lampost as my eye was streaming so much from the pain I didn;t see it!

Mine were possibly caused by being run down and stressed, and I was warned it could come back. Although I used to wear contacts (stopped some time before the ulcer) I have no intention of re-starting as I could do without another one of them!

[BliarOut]

chrisgr31 said:

I had an ulcerated cornea a few years ago, caused they believe by the Herpes Simplex virus, and the treatment was the same stuff used for coldsores (in a different form obviously!). I have never known anything so painful, at the time I was travelling by public transport as I had no car. On my way to the bus stop I actually walked into a lampost as my eye was streaming so much from the pain I didn;t see it! Mine were possibly caused by being run down and stressed, and I was warned it could come back. Although I used to wear contacts (stopped some time before the ulcer) I have no intention of re-starting as I could do without another one of them!

I also get that from time to time when I'm run down. Bloody hurts like hell, doesn't it Glad I'm not the only one

[dxg999]

There's also a bug that lives in tapwater - exists in a cyst stage and a live one in the eye. If she's been cleaning the lenses with tap water rather than cleaning fluid with chlorine in it, then it could be that. About 30,000 people per year in the UK get this thing apparently. Sorry for being a bit vague but google might yield more...

[simpo two]

I had something like that when I was about 14. My father reckoned it was a stye and gave me some 'Golden Eye Ointment' (banned now as it has mercury in it). However it did the trick very quickly.

Is a stye the same as an ulcer?

[mojocvh]

dxg999 said:

There's also a bug that lives in tapwater - exists in a cyst stage and a live one in the eye. If she's been cleaning the lenses with tap water rather than cleaning fluid with chlorine in it, then it could be that. About 30,000 people per year in the UK get this thing apparently. Sorry for being a bit vague but google might yield more...

Hmmm that's very interesting as I'm "due" to have my 5 weekly recurring eye problem shortly....

MoJo.

[968]

simpo two said:

I had something like that when I was about 14. My father reckoned it was a stye and gave me some 'Golden Eye Ointment' (banned now as it has mercury in it). However it did the trick very quickly. Is a stye the same as an ulcer?

I don't think it's the same thing. The ulcer she is describing is on her cornea, ie the clear bit that covers the coloured part of the eye, whereas a stye is an infection of the eyelash follicle in the eyelid.

Golden Eye Ointment is still available, but is bollox. Don't use it, as it causes more toxicity than its worth.

[968]

dxg999 said:

There's also a bug that lives in tapwater - exists in a cyst stage and a live one in the eye. If she's been cleaning the lenses with tap water rather than cleaning fluid with chlorine in it, then it could be that. About 30,000 people per year in the UK get this thing apparently. Sorry for being a bit vague but google might yield more...

You are talking about acanthamoeba......

It's actually not that common, but does indeed occur when lenses are cleaned with tap water. It can be bad news if you get it........ I suspect that it isn't acanthamoeba, but the local unit should be able to differentiate.

[ProPlus]

Update is, the ulcer was over the pupil (black bit) of the eye, the doc in A&E scraped it clean??? Gave her some drops to put in hourly and some cream to put in at night so she didn't have to wake hourly, this will continue for 1 week until it is better. The cause of the ulcer was a slight pit in the eye above the pupil, this allowed dirt to accumulate under the contact lense and resulted in infection.... This happened because the lenses were taken out last thing before bed so not allowing enough blinking and tears to clean the eye naturally, she has now been advised to take the contacts out when she gets back home and wear glasses, this should stop the ulcer returning.... hopefully.

Cheers for all the advice.

Si

[968]

ProPlus said:

Update is, the ulcer was over the pupil (black bit) of the eye, the doc in A&E scraped it clean??? Gave her some drops to put in hourly and some cream to put in at night so she didn't have to wake hourly, this will continue for 1 week until it is better. The cause of the ulcer was a slight pit in the eye above the pupil, this allowed dirt to accumulate under the contact lense and resulted in infection.... This happened because the lenses were taken out last thing before bed so not allowing enough blinking and tears to clean the eye naturally, she has now been advised to take the contacts out when she gets back home and wear glasses, this should stop the ulcer returning.... hopefully. Cheers for all the advice. Si

No probs. I doubt he would be able to scrape the ulcer clean, that's not why you do that, but he would have yielded some material to try to grow some bugs. This will enable him to know which antibiotics the bug is sensitive to. They start broad spectrum treatment, but should see her on a daily basis, until better. The ulcer is caused by use of contact lenses. I don't think when she took them out is a particular issue, but certainly avoiding the lenses should prevent it recurring.