THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 493.5 Guest: Sheri Rowen, M.D., F.A.C.S. Topic: Eye Infections Host: Richard Roeder Producer: Ed Graham

NEMA: This is a discussion about eye infections. My guest is ophthalmologist Dr. Sheri Rowen from the Katzen Eye Group in Baltimore, Maryland.

NEMA: Dr. Rowen, what are the causes of eye infections?

Rowen: Eye infections are caused by two agents one is bacterial and one is a virus. A bacterial infection is like a bacterial infection in the body that requires an antibiotic to clear it up. A viral infection cannot really be treated. It's like a cold where you give supportive drops to help the symptoms and it helps it get better a little bit faster but you can't make it go away.

NEMA: Is there such a thing as a minor eye infection or is any infection in the eye something that should be dealt with professionally?

Rowen: There are minor eye infections. The slight bacterial infection where you get a little crusting, a little redness I'd call that a minor infection but usually they do need to have an eye care professional and be prescribed an antibiotic.

NEMA: Okay. Now what are the usual earliest symptoms of an eye infection, particularly the type that may eventually become serious. What are the earliest signs that something like that is taking place?

Rowen: The first thing that happens is the eye gets red and there'll be some discharge, there'll be some crusting on the lashes, there'll be discharge collected in the corner of the eye and the eye might be painful, not terribly painful but might be scratchy, feel like there's sand in it. If the eye is terribly painful, it's usually something else. There's one infection that can cause a lot of pain. That is a virus. But otherwise most infections that are just conjunctivitis's are not painful. Now if you get an infection of the cornea, that is very painful and that's a serious infection.

NEMA: How often do eye infections lead to blindness or damaged vision?

Rowen: Not terribly often. The vision would be affected if it's an ulcer. It could be infected because an ulcer in the cornea will scar it and depending where the ulcer is located, it would affect the outcome of the vision. If it's on the side of the cornea, it won't have much of an effect but if it's in the center, it could scar it and scar it permanently. If it's a viral infection in the center we can get a virus called herpes simplex in the eye that can scar it tremendously and cause a lot of permanent damage that is one of the viral infections and that needs to also be treated immediately because if it's not, then the scarring will occur and that cannot be reversed at all.

NEMA: I've noticed for years that in spite of the seeming fragility of eyes, they also ultimately seem to have fewer infections than many other systems of the body. Is this an accurate perception? Is there some sort of protective mechanism there?

Rowen: Yes there are. There is a protective mechanism. The tear film is protective. There are certain components in there. The way you get eye infections are touching your eyes with your fingers for the most part.