Wednesday, July 5, 2017

Eye can't handle this...

Forewarning: don't read this if you're grossed out by eyes. Or blood. Or blood clots. Eegh.


After very little thought, I've decided that this new thing I've seen has taken the top spot in the list of GROSSEST STUFF EVER.

I've seriously never been this squeamish before, not even holding traction on crunchy bones or dealing with avulsed fingernails.

The offending thing? Canthotomy. Or more specifically, a lateral canthotomy and cantholysis with both superior and inferior canthal tendons cut for emergency decompression after a retrobulbar hemorrhage during anaesthesia.

Let me put that into basic words, for any non-medical people out there: during the numbing of the nerves behind the eye for cataract surgery, something starts bleeding. That sudden influx of large amounts of blood behind the eye builds up and tries to squeeze the eyeball out of its socket, but pesky anatomy like eyelids and tendons are keeping it in place. The pressure inside the eyeball shoots up to 90 mmHg (normal is 10-21), so an emergency procedure called a canthotomy is done. This procedure consists of cutting the lower eyelid enough to see the tendon holding the eyeball in place, and THEN CUTTING THAT TENDON. If all that doesn't fix the pressure in the eyeball, then you cut the upper lid and tendon too.

Obviously this whole process is a bad outcome for supposedly minor eye surgery but as if that's not enough the patient will uncontrollably bleed because they're on blood thinners too, so they come on in to my ER. Where the doctor will have me take down the dressing to see what's up and I will gently remove said dressing until I reach the eyelid, in which case I'll have to stop because I'm not sure if what's attached to the dressing is clot or eyelid or eyeball and oh god it was so gross I'm getting squeamish just writing this.

I made the doc take over because NOPE. And also because I don't want to be responsible for accidentally pulling someones eye out of their skull. When she got all the dressing and clot out of the way, all you could see was tendon ends, floppy lid, and what theoretically was still an eyeball but pretty much just looked like a handful of red mush.

I'll be fine if I never see (heh) that again, thanks. Once was enough to place this very solidly in the top spot of grossest stuff ever.

1 comment:

Just Me said...

OMG - that sounds disgusting! I can't take anything with fingernails, but that sounds 3000x worse. Did she end up with an eyeball at all?