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All posts for the day June 12th, 2006

This blog has been going for only 1 month but in that time its grown from getting 4-5 hits per day to getting 110+ daily. One memorable day I even had over 300 hits!!! And I didn't even have to mention Angelina Jolie! ;)
So THANK YOU for looking at my blog and for coming back again in many cases. I really appreciate it and it helps spur me on to go out there and take photos of local mosaics and to keep looking around the net.

I'm doing a little bit of a tidyup on the categories section. All of those countries are now under "Mosaics around the world". I'll have a think about how I can rationalise some of the other categories too. Constructive suggestions are always welcome.

If you can think of interesting mosaics, mosaic based websites or anything that can be related back to actual mosaics in any way that I haven't posted about, let me know by adding a comment.

I have a few posts waiting to be posted just that I'm waiting for permission from various people to use their photos. I'm pleased to say that the mosaic community is an incredibly friendly bunch and noone yet has refused my requests and so far everyone has been very encouraging.

And the RSS feed URL is http://mosaik.wordpress.com/feed/ for those of you who want to keep track of what my crazy right brain is up to…

One of the ladies on one of my mosaic mailing lists was trying out her new Leps and when she broke the glass, a shard flew into her eye and she ended up visiting the doc. A scary thing to happen and a very good reason to wear some form of eye protection.

This post is going to be dedicated to things you can do to reduce the risk of eye injury and also will let you know when to panic appropriately. It also tells you what is looked for if you do get injured. I have no sense of decorum when it comes to medical pathology so just be thankful I'm not discussing lungs. This time. That is another post. Just be aware that some of the pics may make normal people feel a bit squeamish. Read it anyway.
So here we go…
eye diagram
Corneal abrasions are very painful but they heal very quickly ie in 1-2 days.

When you go to the doctor, the doctor MUST check your eyesight with a visual acuity chart. [If they don't they are legal idiots and if they are any complications with your injury and someone needs to be sued, the patient has a head start.]

They will also drop a couple of drops of local anaesthetic into your eye which usually stops the pain in its tracks. And they also bring out the orange fluorescein and put a drop or two into your eye. If you are in an emergency department you will end up sitting behind one of these…

slit lamp

slit lamp with fluorescein

Any breaks in the surface of the cornea will show up as that green colour. Here the examination has been done with a slit lamp. This is the ideal.

A GP is much less likely to have a slit lamp unless they are regularly doing this kind of work and earn oodles of money. Many GPs get away with using a Woods light…

Woods light

A foreign body can be either superficial or intraocular.

Superficial ones tend to be found sitting on the cornea or hiding under the eyelid. So the docotr needs to evert your eyelid. It's really easy to do using a cottonbud.

You may score some antibiotic drops too.

If there is any chance that the foreign body could be metal ie you were working with a metal hammer or an angle grinder or something similar, LET THE DOC KNOW. Metal foreign bodies are important because if they are not removed, they rust. The last thing you need is a gob of rust obscuring your vision.

Rust ring

This one is a nice one…easy to find and to remove by scraping away with a burr or a large needle.

burr

[Yes, that sounds awful. Yes, your doc needs a steady hand. But you are the idiot who forgot to use protection. Get the hint?!]

However sometimes the metal penetrates the eyeball. The entry point may be very difficult to see. A wise doc orders an xray or a CT scan to be sure.

IOFB
An intraocular foreign body should not be mucked around with.

From Emedicine.com:


Medical Care: General treatment

  • Minimize pressure on the globe even in cases of self-sealing wounds.
  • Tetanus coverage should be up to date.
  • A delay in management may be complicated by infection.
  • Analysis of 492 patients with IOFBs from the National Eye Trauma System (NETS) registry showed a delay of 24 hours in IOFB removal increased the risk of endophthalmitis from 3.5% to 13.4%.
  • In general, reactive substances, such as copper and iron, should be removed urgently because of the oxidative process these substances can induce on the retina.
  • Vegetable matter poses high risks for endophthalmitis and also should be removed urgently. Substances with inert properties may be removed at a later time after the initial wound is closed.

You'll be pleased to know that I'm not going to show the surgical management. Even I find that rather gory. Ophthalmology is not my favourite branch of medicine. At this point you need a specialist and probably admission to hospital.
And another quote from the same page:


Complications:

  • Corneal opacity

  • Cataract

  • Endophthalmitis

  • Retinal detachment/vitreous hemorrhage

  • Optic neuropathy

  • Siderosis

    • Siderosis is an ocular reaction from iron in either a pure form or an alloy. Iron is the most common element in metallic IOFBs.

    • Heterochromia and degeneration of retinal pigment epithelium is a classic finding.

  • Chalcosis – Ocular reaction to the cooper in alloys

Big words mean trouble in medicine. Ophthalmology words that are big and hard to spell mean serious trouble. Don't risk it.

Prognosis:

  • Dependent on the location and size of the injury as well as the substance involved and the time of removal

  • Posterior intraocular foreign body

    • Favorable with the external approach achieving 20/50 or better in two thirds of patients

    • Internal approaches are not as good because of the selection process of eyes with a higher probability of damage. In one third of eyes, the vision was 20/40 or better; two thirds of eyes obtained 20/200 or better.

So the take home message is that you need either one of these:

Face shield or safety shield

Safety glasses are an okay option but small bits of metal can get past them. But they are cheap. If you are lucky you can find el cheapo versions for $5-10 at Bunnings.
That's where the "cutting inside a bag" trick comes in handy whether its a plastic shopping bag or one made of thicker plastic like the type that duvets come in. It's probably cheaper than the flash shield above which still won't prevent shards flying across the room.
Apparently you can get a face shield at Bunnings for between $30-40. Nice option if you wear specs.

An apple a day won't keep an ophthalmologist away but good eye protection will.

Tectonic plates, originally uploaded by Mazaicist.

How come I can't find plates that look like these?
Obviously people in Darwin just don't have the same taste in crockery.
I like the bright simple colours. Nice and intense without being too intense.
Note the grout changes colour from left to right becoming progressively lighter. It's an interesting effect. I prefer the darker grout especially where the white contrasts so well with the colour. Good effect to try though.

It's a good mosaic that has worked well. Yeah, I'd display it in my house!