She cheered for her big brother as he carried the ball up the football field, but the game could only hold the 5-year-old's attention for so long.
Soon, the girl and her little friends drifted off to play in the adjacent lot. Handfuls of sand were scooped up and tossed around, and the next thing you know, the child was rubbing her face and complaining that something had gotten into her right eye.
The kindergartner came into the exam room with the eye partially closed and a puffy, pink upper eyelid. The child was very cooperative and let me look in the eye with a bright light. I didn't see sand particles or any other foreign body, but a small patch of the upper eye lining did look rough, rather than smooth and glistening.
I applied some fluorescein dye to the girl's eye and examined it with an ultraviolet Wood's lamp. A circular area on the eye picked up the dye and glowed, indicating that the suspicious spot was indeed a superficial eye injury or abrasion.
I instructed the mother to apply antibiotic eye drops to prevent infection, and asked her to call if the eye wasn't improving on a daily basis. On a return visit a few days later, I was pleased as the girl walked in with a big smile and a healthy appearing eye that no longer "lit up" on dye exam.
Corneal abrasions are superficial scrapes to the outer lining of the eye. Experts at the National Institutes of Health explain that corneal abrasions can result from damage due to chemical irritants, contact lens overuse, scratches, foreign bodies or light exposure.
In an article in the American Family Physician journal, Drs. Stephen Wilson and Allen Last report that corneal abrasion is the most common pediatric eye injury treated in emergency rooms. Injured children can complain of pain, tearing, light sensitivity and a feeling of grit or foreign body in the eye. Though painful, simple corneal abrasions involve only the very top layer of the cornea -- the outer epithelium -- and heal within 24 to 72 hours.
Wilson and Last note that eye patching is no longer routinely used in the treatment of corneal abrasion. Patching does not appear to help reduce eye pain or speed the healing process in corneal abrasions, and has been linked to an increased risk of eye infection. Because it interferes with binocular vision, patching an abraded eye can also cause affected children to have difficulty walking.
To help prevent corneal abrasions, the family physicians advise the use of protective eye wear for individuals involved in higher risk jobs and sports such as woodworking and racquetball. Other practical suggestions include the proper fitting and use of contact lenses, frequent clipping of infant and toddler fingernails, and clearing low-hanging tree branches from play areas.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.