A doctor at Fooyin Hospital in Taiwan recently described pulling four bees out of the eye of a patient who was complaining of extreme pain, swelling and tearing, according to news reports from CTS News in Taiwan and the Washington Post.
The 29-year-old had participated in a traditional Tomb Sweeping Day the previous day and felt something get in her eye while cleaning a relative’s grave. She flushed out her eye but began experiencing a stinging pain later that evening. Four live sweat bees, which were feeding on the woman’s tears, were pulled from her eye, the hospital’s head of ophthalmology, Hung Chi-ting, told the media.
While finding bees in a patient’s eye is a rare occurrence, foreign objects, dirt and debris are common causes of injury and pain. As spring gears up and more people are tending to gardens and performing outdoor activities, that risk increases.
Healio.com/OSN spoke with Cynthia Matossian, MD, FACS, about this topic, along with the best ways to prevent and treat eye injuries caused by dirt and debris.
Healio.com/OSN: How common is it for gardening or other outdoor activities to contribute to eye injuries or infections?
Matossian: It is not uncommon for anyone who gardens or works outside with plants to get a wide variety of materials in their eyes. Very commonly, a fine dusting of soil coats the face and eyelids from working with mulch or potting dirt in the sun. Perspiration loaded with these microparticles then drips into the eye, causing irritation, redness and grittiness. Dirty hands, perhaps those that have touched fertilizer or other chemicals, are then used to rub the eyes, making the situation even worse. Pollen during the spring can get into eyes, causing an allergic reaction for those who are sensitive to specific allergens from shrubs, grasses or blooming trees. An allergic reaction can lead to swelling of the eyelids, redness and edema of the conjunctiva, tearing and itching. Other items that I have personally seen in the eye are thorns from cacti plants. Depending on the species, some cacti have very stiff, long and sharp thorns that can lead to a puncture injury of the cornea. Pine tree needles from a Christmas tree can cause corneal or conjunctival abrasions, leading to pain and tearing. I had a patient who came to our office on an emergency basis with a foreign body sensation in her eye, chronic redness for a few days and discomfort. She had the hairy leg of an insect embedded in her cornea. I don’t know what insect it was as only the leg was fully embedded in her cornea. I had to take her to the minor procedure room and remove the insect leg under magnification. Fortunately, she recovered her full vision without any corneal scar formation.
Healio.com/OSN: What are the best ways to avoid getting insects or debris in the eye when tending to gardens and graves or performing other outdoor activities?
Matossian: Wraparound glasses or sunglasses that have sides and a protective rim all around are excellent ideas. There are gardening hats with face protection consisting of a fine mesh.
Healio.com/OSN: What are the common ways of treating foreign objects in the eye, and what should your fellow ophthalmologists look for if they come across something unusual?
Matossian: Always get a good history from the patient and do a thorough slit lamp exam using fluorescein dye. The key step is to evert the lids and sweep underneath with a cotton swab. It is also a very good idea to examine the contralateral eye — many times I have found foreign bodies in the opposite eye in addition to the eye that is more symptomatic, for example, metallic foreign bodies from working under a car.
Healio.com/OSN: The patient in Taiwan described hours of painful itching and swelling and did not seek treatment until the following day. When would you suggest seeking treatment in these cases?
Matossian: If someone feels a foreign body in their eye, here are a few simple steps to follow:
- Wash hands with soap and water.
- Flush eyes immediately with a gentle stream of water — tap water is fine.
- Do not rub eyes.
- Take contact lenses out if you wear contacts.
- If you experience pain, decreased vision, redness or a sensation that there is something in the eye that does not improve over a short period of time, please call an eye care professional and seek help as soon as possible. – by Rebecca L. Forand
Disclosure: No products or companies that would require financial disclosure are mentioned in this article.