I think that, if you asked people what sense they would least like to lose in the quest for survival, it would be the sense of sight. In part 1 of this rarely-discussed series on vision issues off the grid, we talked about the complex structures in the human eye and their function, plus some childhood vision issues the medic might encounter, such as the “lazy eye.” In this, part 2, we’ll talk about some problems that can occur in childhood, but also in adults: eye infections.
Eye Infections
conjunctivitis
There are various eye conditions that will be more common in a grid-down situation. The most common will be “conjunctivitis,” also known as “pink eye.” The conjunctiva is the thin membrane that covers the white of your eye. Conjunctivitis is an inflammation which can be caused by chemical irritation (soap in your eyes, for example), allergies, a foreign body, or an infection.
Pink eye caused by microbes is highly contagious among children. They tend to rub their itchy eye and then touch other children or items. Studies have shown that people commonly touch faces and eyes with their (often dirty) hands throughout the day. Observe any family member for a half hour and you’ll see this is true.
Symptoms of Conjunctivitis
Symptoms can vary depending on the cause (viral, bacterial, allergic, or irritant), but common ones include:
- Redness or pink color in the white of one or both eyes
- Itching, irritation, or a gritty/sandy feeling in the eyes
- Excessive tearing (watery eyes)
- Discharge from the eye, which may be watery (viral/allergic), thick/pus-like (bacterial, often yellow or green), or crusty (causing eyelids to stick together, especially in the morning)
- Swelling of the conjunctiva or eyelids
- Burning or discomfort in the eyes
- Sensitivity to light (in some cases)
- Blurred vision (usually mild and due to discharge/tears)
You can often tell the cause of the problem. If caused by viruses or allergies, the affected eye becomes red, watery, and itchy. A runny nose may accompany it. If caused by a bacterium, you may note a milky yellow or green discharge. The discharge forms a crust when it dries; the patient may even complain of eyelids “stuck together” upon awakening.
Treatment of Conjunctivitis
Although antibiotic eye drops like tobramycin are more popular for conjunctivitis, oral antibiotics like Doxycycline 100 mg twice a day for a week or less will also relieve bacterial conjunctivitis. Antihistamine eye drops like ketotifen fumarate (Zaditor) are useful for eye allergies and available over the counter. Warm compresses can loosen hardened crusts.
Herbal treatment may also be of benefit. To treat pinkeye using natural products, pick one or more of the following methods:
- Apply a wet Chamomile or Goldenseal tea bag to the closed, affected eye for 10 minutes, every two hours.
- Make a Chamomile or Eyebright (Euphrasia officinalis) tea, let cool, and use the liquid as an eye wash (using an eyecup) three to four times daily.
- Use 1 teaspoon of fresh baking soda in 2 cups of cool water as an eye wash solution.
- Dissolve 1 tablespoon of raw honey in 1 cup warm water; let cool, and use as an eye wash.
For compresses, moisten with any of the above tea, baking soda, or honey solutions on gauze or cloth, and then apply a compress to the affected eye for 10 minutes every two hours. For relief from the discomfort of conjunctivitis, a slice of cucumber over the eyes will have a cooling effect. If no treatment options exist at all, conjunctivitis usually resolves on its own after a few days, but may take up to two weeks.
Irritated, teary, red eyes from allergies can be treated with oral antihistamines or eye drops, important additions to the survival medicine cabinet. Lubricating drops for dryness may help.
Preventing Conjunctivitis (Pink Eye)
To avoid spreading the germs that can cause eye infections:
- Wash your hands regularly.
- Don’t share eye drops with others.
- Don’t touch the tip of a bottle of eye drops with your hands or your eyes because that can contaminate it with germs. Always keep the bottle two or three inches above your eye.
- Don’t share eye makeup with others.
- Never put contact lenses in your mouth to wet them. Many germs exist there that could cause infections.
- Change your contacts often. The longer they stay in your eyes, the higher the chance your eye can get infected or traumatized.
What should you have in your survival medical supply cabinet for eye issues? Check out this eye kit to see.
By the way, any time you have an eye examination, ask the doctor if they have any samples of medicated eye drops available, like tobramycin, polymyxin B, and neomycin. Apply 1 or 2 drops to the affected eye three times a day for 5-7 days.
Styes
Stye
A “stye” is a bump on the eyelid. It presents as a pimple that can be outside or inside. Styes are caused by a blocked gland near an eyelash due to an accumulation of bacteria called Staphylococcus aureus (Staph).
Luckily, styes do not affect vision unless they become very large, which is a rarity. Normally, they tend to grow, “pop,” and drain, then go away after a few days. Despite this, there is often a sense of urgency to deal with it, due to the discomfort and cosmetic appearance.
Symptoms of Styes
Symptoms of a stye include:
- Swelling, often with a yellowish bump at the base of an eyelash
- Redness
- Warmth
- Discomfort
- Discharge and crusting around the area
A stye is sometimes confused with another condition called a “chalazion” A chalazion is caused by the blockage of eyelid gland ducts that excrete an oily substance which lubricates the eye. Styes develop quickly, but a chalazion forms over a longer period (sometimes in the area of a previous stye). Unlike styes, a chalazion is painless, but just as disfiguring. A chalazion might resolve on its own over a period of weeks or months.
Treating Styes
The simplest way to deal with a stye is to apply warm moist compresses for 10 minutes twice or three times a day. This helps the stye drain faster and go away. In between, clean gently with a cotton ball or swab in warm water. Antibiotic eye solutions and ointments are also available that will help to speed recovery. Use acetaminophen or ibuprofen for pain relief if needed.
If a patient gets styes often, it’s time to evaluate their hand washing practices. Most people don’t wash their hands as often as they should, and this can cause infections like styes or conjunctivitis. This is especially an issue for those who wear contacts. A good method of prevention is to perform eyelid scrubs regularly with a warm moist cotton ball or gauze pad and a small amount of baby shampoo.
Many people will try to squeeze the stye like any other pimple, but this can traumatize the area and cause spread of the infection to surrounding tissues. This is called “cellulitis” and is discussed elsewhere in this book. If the cellulitis spreads to the face, you should give your patient oral antibiotics in the penicillin, erythromycin, or cephalosporin families.
Natural remedies for styes include:
- Warm saline solution washes or compresses several times a day.
- Coriander or tamarind seed washes to reduce swelling. Soak seeds in warm water, then strain and use the water as a wash for your eye.
- Warm tea bags to the area; the tannic acid in teas may be helpful.
In the next part of our series, we’ll discuss some common vision defects, why they happen, and what you can do about if the you-know-what hits the fan.
Joe Alton MD
Joe Alton MD. aka Dr.Bones
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