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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7364
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My wife recently had a plastic bag hit her in the eye and now

Customer Question

My wife recently had a plastic bag hit her in the eye and now has blepharospasm and epiphora. As a vet I ran her into my office and performed a flourescien stain and it came back positive with a 2 mm laceration on her cornea. I brought home atropine and ciprofloxacin opthalmic solution. She is breast feeding. Would it be prudent to begin treatment on her eye with these medications?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

I actually treated my horse for a corneal abrasion once....welcome to my side of the fence :-)

Dr. Rick :

I would expect that she has a corneal abrasion rather then an actual laceration of the corneal stroma.

Customer:

Oh yeah. What should I do? It uptook stain

Dr. Rick :

The atropine,while is should not be a problem with breast feeding, will dilate her eye for about 3 weeks.

Dr. Rick :

Do you have cipro drops or ointment?

Customer:

drops

Customer:

0.3%

Dr. Rick :

Ok. She is not going to be very happy tonight. When she goes into REM sleep it is going to really hurt.



The good news? Things should heal up within 24 hours.

Customer:

So should she use the antibiotic eye drops or not?


 

Dr. Rick :

That is a very good drop. You could put in one drop QID and that will be OK.



I would hold off on the atropine as she really doesn't need an agent that works for 3 weeks for the 24 to 36 hours of photophobia and blepharospasm she is going to have.

Customer:

for just a few days?


 

Dr. Rick :

I normally don't use antibiotic drops for a corneal abrasion. I usually put on a pressure patch with an antibiotic ointment, such as erythromycin or -- to tell the truth -- whatever I have in my desk drawer -- The risk of corneal infection in these injuries is very, very low.

Dr. Rick :

One the epithelium is intact, which usually happens in 24 to 36 hours, the risk of infection is pretty much gone...so no need for further coverage.

Customer:

so should she not open her eye is that what they eye patch is doing


 

Dr. Rick :

The pressure patch really helps with the pain. Make sure the patch is tight and the eye closed...if it comes open under the patch it can really cause a bad abrasion.

Dr. Rick :

A very good study a decade or so ago showed that a corneal abrasion heals just as fast and just as well if left alone or if patched with antibiotic ointment. The only difference was that the patched patients were more comfortable.

Dr. Rick :

Plus, if a patient comes to my office in pain with an abrasion they expect me to do something "doctorely"......so a patch it is :-)

Dr. Rick :

I bet you do that as a vet sometime too.....

Dr. Rick :

Is this information helpful?


 

Dr. Rick :

My family owns a large riding stables where I grew up. Are you large, small or mixed animal vet?

Customer:

dog and cat only


 

Dr. Rick :

And you are correct in your post....steroids at this point will just slow healing an increase infection risk.

Customer:

we feel better, at least she wont go blind

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7364
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
No she won't go blind and, although things will be a bit painful everything should be OK.

Have a good weekend.

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