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“I want an official Red Ryder, carbine action, two-hundred shot range model air rifle!”
“No, you'll shoot your eye out.”
This line from “A Christmas Story” is one of the most memorable Christmas movie quotes ever. Funny in the movie, but the holiday season does present a real eye injury threat.
For those who celebrate Christmas, that risk begins even before the actual day.
Some of the most frequent holiday-related eye injuries come from the Christmas tree itself.
Holiday eye safety begins with the acquisition of the tree. If you are cutting down your own tree, please wear eye protection when doing the cutting--especially if you are going to be using a mechanical saw, such as a chain saw or sawzall. You need to also be careful of your eyes when loading a tree on top of the car. It is easy to get poked in the eye when heaving the tree up over your head.
Once back at home, take care to make sure no one else is standing close to the tree if you had it wrapped and now need to cut the netting off. The tree branches often spring out suddenly once the netting is released.
Other injuries occur in the mounting and decorating phase. Sharp needles, pointy lights, and glass ornaments all pose significant eye injury risk. If you are spraying anything like artificial tree snow on the branches be sure to keep those chemicals out of your eyes.
Having now successfully trimmed the tree without injury, let’s move our holiday eye safety talk to the toys.
We want to spend the holiday happily exchanging gifts in front of a warm fire, drinking some eggnog, and snacking on cookies--not going to the emergency room with an injury.
The Consumer Product Safety Commission reported there were 254,200 toy-related emergency room visits in 2015, with 45% of those being injuries to the head and face--including the eyes.
In general, here are the recommendations from the American Academy of Ophthalmology in choosing eye-safe toys for gifts:
- “Avoid purchasing toys with sharp, protruding or projectile parts."
- “Make sure children have appropriate supervision when playing with potentially hazardous toys or games that could cause an eye injury."
- “Ensure that laser product labels include a statement that the device complies with 21 CFR (the Code of Federal Regulations) Subchapter J."
- “Along with sports equipment, give children the appropriate protective eyewear with polycarbonate lenses. Check with your eye doctor to learn about protective gear recommended for your child's sport."
- “Check labels for age recommendations and be sure to select gifts that are appropriate for a child's age and maturity."
- “Keep toys that are made for older children away from younger children."
- “If your child experiences an eye injury from a toy, seek immediate medical attention.”
More specifically, there is a yearly list of the most dangerous toys of the season put out by the people at W.A.T.C.H. (world against toys causing harm).
Here are types of toys to avoid:
- Guns that shoot ANY type of projectile. This includes toy guns that shoot lightweight, cushy darts.
- Water balloon launchers and water guns. Water balloons fired from a launcher can easily hit the eye with enough force to cause a serious eye injury. Water guns that generate a forceful stream of water can also cause significant injury, especially when shot from close range.
- Aerosol string. If it hits the eye it can cause chemical conjunctivitis, a painful irritation of the eye.
- Toy fishing poles. It is easy to poke the eyes of nearby children.
- Laser pointers and bright flashlights. The laser or other bright lights, if shined in the eyes for a long enough time, can cause permanent retinal damage.
There are plenty of great toys and games out there that pose much lower risk of injury so choose wisely, practice good Christmas eye safety, and have a great holiday season!
Article contributed by Dr. Brian Wnorowski, M.D.
This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.
There is a common misconception that any adverse reaction to a drug is an allergy. That is definitely not the case.
Reporting to your doctors that you have an allergy to a medication when what you really had was a side effect could potentially create a substantial alteration to your medical care in the future. And this could mean a physician might avoid using a drug that could possibly save your life because of the fear of an allergic reaction.
An anaphylactic allergic reaction generally produces a very specific set of symptoms, including difficulty breathing due to constriction of windpipe, swelling of your tongue, and/or a rash and hives that break out over your body. While an allergic reaction can present in other ways, these are the most frequent reactions that occur when you have a true allergy to something.
If that is not the type of reaction you had then it probably isn’t an allergy. If you are uncertain if your reaction to a medication is an allergy or not, testing by an allergist may be able to tell you if your reaction was a true allergy or a side effect.
It is not always just the patient who can misdianose a side effect as an allergy. Sometimes it is the doctor or the dentist who tells the patient, “You must be allergic.” This is a quick and easy explanation but not always the correct one.
In optimal medicine, there are not always a lot of “lifesaving” incidences, but there are several drugs that are the preferred treatment for certain conditions and if you report an allergy to these drugs it may make your doctor use a much less effective drug.
Here are some specific examples of when a false report of an allergy may lead to less effective treatment or even failure to offer life-saving treatment.
Epinephrine
The most common potential “lifesaving” drug to which patients sometimes report an allergy to is Epinephrine.
The story usually goes something like this: “I was having a dental procedure and soon after the dentist injected my mouth with a local anesthetic of lidocaine with epinephrine my heart started racing and pounding out of my chest and I almost passed out.” This hypothetical patient may come to the conclusion or the dentist may mention that the patient is allergic to epinephrine. That reaction is almost never an allergy but a side effect that occurs when a substantial dose of the lidocaine and the epinephrine gets into the blood stream and stimulates the heart.
The mouth and gums are very vascular, and it is easy to have some of that injection end up in the bloodstream, but that reaction is not an allergy and should not be reported as such.
Epinephrine is used to treat severe (anaphylactic) allergic reactions and not using it if you were to ever have a severe allergic reaction could lead to some very bad outcomes. This is not to say you can’t be allergic to epinephrine. You can, but it is extremely rare. If there is any doubt you should be tested by an allergist before you ever record yourself in a medical setting as being “allergic” to epinephrine.
Cortisone/Steroids
Cortisone is a highly effective drug to treat many conditions. Again, it is unlikely but not impossible to be allergic to it.
We all have naturally occurring cortisol circulating in our bodies and cortisone is a very similar molecule but not exactly the same. Cortisone also can have a wide range of side effects depending on where and how it is administered
Some of the common side effects of cortisone, which have been mislabeled as an allergy, are: Making your blood sugar rise, insomnia, mood swings, nausea, and weight gain. These are all known side effects of the drug and not allergies. Cortisone side effects are associated with only certain routes of administration and are often dose dependent.
Why is this important in terms of your eye care? We often use cortisone derivatives, like Prednisolone, to fight inflammation that may occur in your eye, particularly after any ocular surgery. If you report that you are allergic to cortisone when you really only experienced a side effect, we are going to have to use a less-effective medication to deal with your eye inflammation.
As I mentioned above, most side effects are dose dependent and the dose you got in a pill may have caused a side effect you’d rather not have again but the dose in an eye drop is significantly less and highly unlikely to give you the side effect you got with a pill taken orally.
Antibiotics
People often report they are allergic to antibiotics when they really experienced a side effect.
The most common side effect with oral antibiotics is some type of gastrointestinal disturbance, like nausea, or diarrhea. If that was what you had and just prefer not to get that again you still shouldn’t report it as an allergy. If you do, then the drug can’t be used as an eye drop or ointment that might be the best treatment for your condition.
An antibiotic eye drop/ointment is very unlikely to produce the same gastrointestinal trouble that the same antibiotic gave you when given as a pill. You don’t want to take away the most effective treatment for your problem because you mislabeled a side effect as an allergy.
Sedatives/Anesthesia
Most of the time with these drugs the issue is how you felt either during or after a procedure.
Common comments are “it took me too long to wake up” (side effect not an allergy); “the sedative I got in my IV burned when it went in” (side effect not an allergy); “I was sleepy all day” (side effect not an allergy); “I was nauseous after the procedure” (could be an allergy but much more likely to be a side effect).
Why are these important? We can make you much more comfortable for a local anesthesia procedure if we can use some sedation. Using sedation may be better for you and the doctor performing the surgery because you are much less likely to move during the surgery if you are resting comfortably.
If you ever have an untoward reaction to a medication it is worth your time and effort to really probe into the issue to figure out if what you had was really an allergy or just a side effect because sometimes your life may depend on it.
Article contributed by Dr. Brian Wnorowski, M.D.
This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.
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