In a sense, every doctor’s birthday is July 1st.  This is the day our training begins, with each subsequent first of July marking another step up the residency food chain.  I’m now entering my sixth year with MD after my name and my third since finishing residency.  Literally tens of thousands of patients seen, and yet stuff still walks through the door that I’ve never seen before.  As an old attending once told me, the variety is a curse at the beginning of your career and a blessing at the end. 

So not too long ago I saw for the first time a lady who had glued her eye shut.  For the record if you are so inclined to wear fake nails, and go on to catch pink eye, and are prescribed antibiotic drops as opposed to ointment, whatever you do don’t store the antibiotic drops next to the nail glue.  These bottles look awfully similar, and in her case she picked up the wrong one, looked up at the ceiling, squeezed, blinked, and just like that her eyelids were fastened tight.

She was doing her best to maintain her composure, but not being able to open her eye was making her unsettled to say the least.  Unfortunately she chose the worst possible time to do this – early on a Friday evening.  I thought I remembered being taught to leave this kind of thing alone and let ophthalmology handle it, but it felt wrong to send this lady home as much as it was bothering her and have her sweat it out until Monday finally came around.

We are a one ophthalmologist town, and though he stopped taking ER call long ago he remains available for phone consultation.  I had him explain to me what he would do for this, and came up with the following plan: try to get the eye open myself and, if that failed, try to convince the nearest on-call ophthalmologist to accept her in transfer.

Colace is normally used to soften hard constipated poop, but it turns out it makes superglue alot softer too.  After soaking her eye in it for thirty minutes or so, I gently pulled her eyelids apart and this time a small area off to the side came free.  Using some scissors we normally use for stitches, I placed the point into the open area between her eyelids and eyeball and begin cutting through the glue.  After a few snips I managed to free the lids and she was able to once again open her eye.  I then found a big chunk of glue underneath her upper lid that easily came out with some hemostats.  After that all that remained were several small shards of glue under both lids that I managed to meticulously remove with the hemostats and some cotton swabs.

It was fantastic.  She was so incredibly happy and relieved and grateful to have her eye open, and I felt the same way about how smoothly the process of getting her eye open went.  It’s interesting, I don’t think I would have been capable of doing something like that at the beginning of my training.  But now, even though it was my first time to free up an eye, I’ve had so many other first time experiences with central lines and chest tubes and stitches and the like that I’ve conquered alot of the fear and hesitancy that comes with performing any new procedure.  You have to know the limits of what you can appropriately do of course, but at the same time you have to be capable of doing invasive things to other people for the first time on your own as a still relatively new ER doc.

I switched her over from antibiotic eye drops to ointment to avoid any further confusion.  Although now that I think about it, the ointment looks and awful lot like Krazy Glue.  Uh-oh.

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