Monthly Archives: June 2016

Eye Injuries from Fireworks on the 4th of July

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Although we all love to celebrate the 4th of July, it is important to take action to avoid blindness from accidents involving the use of fireworks.

I will never forget the sorrow I felt for the family of a beautiful 2-year old girl who lost her vision from an accident many years ago on the 4th of July. Her family had earnestly wanted to share the joy of the holiday with their toddler. They purchased some bottle rockets and placed the child far away from where her father lit the rockets. Unfortunately, one of the rockets fell to the side and spun around and around the family. It finally exploded in front the young child before her parents could offer protection. The particles from the casing fractured from the explosion and flew in all directions. Several of the red plastic chards struck the child in her eyes. I was called on to care for her in the emergency room. As the family watched fearfully, I examined the child and determined that she needed to be treated in the operating room as an emergency. I operated for many hours, removing pieces of shrapnel from both eyes. Eventually, I was able to suture the eye lacerations closed. Several additional surgeries were required. Although I was able to save her from total loss of vision, she was legally blind. Permanently. For the rest of her life.

This sad experience prompts me to write this blog prior to the festivities on the 4th of July. To minimize the risk of injury, I ask that parents take their families to see professional displays of fireworks rather than putting on their own shows. Even sparklers can cause severe skin and eye burns due to the high temperatures at which they burn. If you suffer an injury, please report without delay to the emergency room of your local hospital for care.

Please keep the family celebrations fun and safe this year.

By Scott E. Pautler, MD

See also:

http://www.aao.org/eye-health/news/teen-nearly-loses-vision-to-fireworks

http://www.aao.org/eye-health/tips-prevention/injuries-fireworks-eye-safety

Metamorphopsia (Visual Distortion)

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globe anatomy
anatomy of the eye (click on image to enlarge).
Image courtesy of Caitlin Albritton.

What is metamorphopsia?

Metamorphopsia (“meta-more-FOP-see-ya”) is a medical term used to describe an abnormal visual perception in which images appear distorted. For example, straight lines appear curved or jagged. It is an important symptom of retinal disease. Metamorphopsia is not caused by the need for new glasses, cataract, glaucoma, or optic nerve damage. Metamorphopsia is a sign of a retinal problem. It is detected and monitored with an Amsler grid.

Distortion
Distortion of lines on Amsler Grid in right eye (click on image to enlarge)

What causes metamorphopsia?

The retina is a thin layer of nerve tissue that acts like film inside a camera. The retina “takes a picture” and sends the image to the brain. The root cause of distortion in vision is a retina that is not smooth and flat against the eye wall. This distortion of the retina may be caused by many different conditions. Sometimes, problems under the retina cause fluid leakage resulting in metamorphopsia. Such conditions include macular degeneration, central serous retinopathy, histoplasmosis, high myopia, angioid streaks, and inflammation. In other situations, distortion may be caused by scar tissue under the retina from inflammation, trauma, bleeding, or chronic leakage of fluid under the retina. Distortion of the retina may also be caused by vitreomacular traction, macular hole, or macular pucker. The ophthalmologist (retinal specialist) will undertake examination and testing to determine the cause.

Is metamorphopsia an urgent situation?

Metamorphopsia may be an urgent situation if it is new in onset or has significantly increased recently. If the cause of distortion is inflammation or bleeding, prompt treatment is needed to prevent further loss of vision and worsening of symptoms. Longstanding distortion is less likely an emergency but merits an eye examination to determine the cause.

What is the treatment?

Metamorphopsia is a symptom rather than a diagnosis, so the treatment depends on the underlying cause of the distortion of vision. This is the reason why it is important to have an eye examination in order to determine the best course of action. Contact your eye doctor or retinal specialist if you have this important symptom.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida.

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