Eye Care: Addressing Concerns After Pupil Dilation

Q: Eye Care: Addressing Concerns After Pupil Dilation

Hello： Based on the situation you described, I would like to provide the following recommendations： Q1. It is unlikely to cause any harm. Q2. If the lower white part of the right eye (sclera) is poked or scratched, the following symptoms may occur： - Sharp

Inquiry for clarification?

Dear Dr.
Gao,
Thank you very much for your previous response to my questions; I have understood everything clearly.
I apologize for bothering you again, but I have a sudden issue with my eye that has caused me some concern, so I am reaching out once more.
Today (March 22), I followed your advice and visited an ophthalmology clinic for an examination, which included a general check-up and a dilated fundus examination.
After the examination, the ophthalmologist concluded that there were no significant issues with my eyes (such as cataracts, glaucoma, retinal disease, or macular degeneration).
I also mentioned that the double vision I experience when reading disappears when I wear glasses.
Based on the examination results and my description, the doctor assessed that the double vision I experience without glasses is likely due to my myopia (or astigmatism) rather than any pathological changes in my eyes, which has relieved my concerns.
Before the fundus examination, the nurse administered a dilating agent.
She used a long cotton swab to pull down my lower eyelid while applying the dilating agent with her other hand.
The application went smoothly for my left eye, but when she applied it to my right eye, I am not sure if it was due to her quick movement or my head shifting, but the cotton swab slightly touched the sclera of my right eye.
I felt a sharp pain and instinctively flinched, after which I experienced a slight dull pain in my right eye.
The nurse apologized and then applied the dilating agent to my right eye again.
After resting my eyes for about 20-30 minutes, I went into the examination room for the fundus examination, which yielded the results mentioned above: both of my eyes showed no abnormalities.
Currently, my right eyeball appears normal, with no obvious bleeding or scars, and there is no significant pain; my vision is relatively normal, although there seems to be slight blurriness and a mild foreign body sensation (possibly due to the lingering effects of the dilating agent).
I would like to ask Dr.
Gao the following questions:
Q1: Based on the above, since the cotton swab slightly touched the sclera of my right eye during the application of the dilating agent, and considering that I underwent a fundus examination 20-30 minutes later with no abnormalities found in either eye, can we confirm that the slight contact did not cause any damage to the structural components of my right eye, such as the retina, optic nerve, or macula?
Q2: If the cotton swab did cause a scratch or abrasion to the sclera of my right eye, what symptoms would typically manifest to indicate such an injury?
Q3: Since it is currently unclear whether there is a scratch or abrasion on the sclera or any other part of my right eye, can I choose to observe the situation without seeking immediate medical attention? Additionally, what symptoms would necessitate immediate medical evaluation?
Thank you, Dr.
Gao.

Kris, 40~49 year old female. Ask Date: 2024/03/22

Dr. Gao Pilin reply Ophthalmology

Hello: Based on the situation you described, I would like to provide the following recommendations:
Q1.
It is unlikely to cause any harm.

Q2.
If the lower white part of the right eye (sclera) is poked or scratched, the following symptoms may occur:
- Sharp pain or burning sensation in the eye
- Redness, swelling, or bleeding in the eye
- Increased eye discharge
- Increased sensitivity to light
- Sensation of a foreign body or irritation
Q3.
You can monitor the condition of your eye, but if any of the following occur, it is advisable to seek medical attention immediately:
- Persistent severe pain or discomfort in the eye
- Noticeable redness, swelling, or bleeding in the eye
- Decreased vision or any abnormalities such as blurriness or loss of focus
- Increased eye discharge accompanied by fever
- Persistent increased sensitivity to light
However, the situation you mentioned should not cause any injury to the eye.

Reply Date: 2024/03/22

More Info

Hello! Thank you for your detailed questions regarding your recent eye examination and the concerns you have about potential injury from the eye care procedure. It's completely understandable to feel anxious after an unexpected incident during an eye exam, and I'm here to help clarify your concerns.

Q1: Regarding the potential injury from the cotton swab during the dilation process:
Based on the information you provided, it seems that your eye examination results were normal, which is a positive sign. The fact that your retina, optic nerve, and macula were assessed and found to be without abnormalities suggests that the cotton swab incident did not cause any significant damage to the deeper structures of your eye. Typically, minor contact with the sclera (the white part of the eye) during such procedures does not lead to serious injury, especially if there are no visible signs of trauma or bleeding. However, if you experience any persistent discomfort, changes in vision, or other unusual symptoms, it would be prudent to follow up with your eye care provider.

Q2: Symptoms of scleral injury:
If the cotton swab had caused a scrape or abrasion on the sclera, you might expect to see symptoms such as:
- Redness in the white part of the eye (scleral injection)
- Increased tearing or discharge
- Sensitivity to light (photophobia)
- A sensation of something being in the eye (foreign body sensation)
- Pain or discomfort, which may vary from mild to severe
If you notice any of these symptoms, it would be advisable to seek medical attention to ensure proper evaluation and treatment.

Q3: Observation and when to seek medical attention:
Given that you currently do not have significant symptoms and your eye examination was normal, it is reasonable to monitor your condition for a short period. However, you should be vigilant for any of the symptoms mentioned above. If you experience any of the following, you should seek immediate medical attention:
- Sudden changes in vision (blurriness, loss of vision)
- Severe pain or discomfort that does not improve
- Persistent redness or swelling
- Any discharge from the eye that is unusual or concerning
- Increased sensitivity to light
In summary, while it appears that your eye has not sustained any serious injury, it is always best to err on the side of caution. If you have any doubts or if symptoms develop, do not hesitate to contact your eye care provider. Regular follow-ups and open communication with your healthcare team are essential for maintaining eye health, especially given your history of eye conditions.
Take care, and I hope your eye continues to feel better!

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