The phone rang and she told us her story. She had been using a little metal comb to do something to her eyelashes – don’t ask me what, but you women out there might know- and she accidentally scraped her eye. Could she come in right away and have me take a look and stop it from hurting? Of course, Lavon the receptionist said, and a short time later Susan (not her real name) came in the office for me to see.
We took a look at the little metal comb she was using – to me it looked like a medieval torture instrument – and I thought, NO WAY would I ever get anything like that close to MY eye. Anyway, I took a look at her eye with the slit lamp bio-microscope that we eye doctors use to examine the eye and saw that she indeed had scraped the cornea of her eye.
I took a picture of her eye with the scrape on it and kidded her that it looked like a salamander. I wouldn’t have been in a kidding mood if I thought the eye was permanently damaged, but I knew that the cornea is one tough little membrane that protects the eye with military efficiency. It is only 1/50th of an inch thick, but is composed of 5 distinct layers. The outer layer is the epithelium and it is only 1/500th of an inch thick. It is on top of the next layer which is even thinner that is called Bowman’s membrane. Bowman’s membrane is very tough and resists penetrations by most foreign bodies – but not needles, knives, bullets or mascara instruments of dubious safety!
Corneal Abrasion
Susan had scraped her epithelium and I knew that if I put an antibiotic and a bandage lens on the cornea it would feel better right away and heal up quickly. Sure enough, when she came back for her visit the next day, to make sure all had gone well, she was almost completely healed.
The epithelium is a very important layer of the cornea. We now know that “dry eye” – which causes symptoms of dry, irritated, scratchy, uncomfortable eyes and also causes unstable vision- is actually a disease of the ocular surface, which includes the epithelium, conjunctiva, lacrimal and meibomian glands. Fortunately, our ability to treat these problems has EXPLODED in just the last couple of years. It’s not just about moisturizing drops anymore! More, much more, later.
Dr. David Littlefield
