Eye Injuries Caused by Superglue...Yeah, it Happens

The first time I saw a patient in the emergency department who had mistaken a superglue bottle for Visine, it seemed like a once in a lifetime situation. I mean, who keeps hard core adhesive on their nightstand? Then, it happened again. And again. 

While I certainly don't treat patients with super-glued eyelashes on a daily basis, it happens more than you would think. The incident is so common, in fact, that even prestigious academic publications like the British Medical Journal have covered the topic. In 1982, superglue, also known by its technical name cyanoacrylate, was repackaged into eye-dropper like bottles. Since then, people with poor vision, children, and those who are careless have inadvertently sustained ocular superglue injuries. Fortunately, a superglue to the eye situation is an easy one to fix.

Let's look at the various ocular injuries caused by superglue and their treatment. 

Tarsorrhaphy- Eyelids or Eyelashes Stuck Shut

When superglue adheres to the skin, in most cases it can be easily removed with acetone. But, rubbing acetone over your eyes is of course inadvisable. In the case of eyelashes that are glued shut (technically dubbed tarsorrhaphy- bet you didn't learn that in nursing school!), first rinse the area with warm water. If this is done immediately after exposure, some of the glue may be washed away. If the tips of the eyelashes or just one or two lashes are affected, you can try to manually separate them but never, ever, ever, force them apart. Another approach is to trim the few affected lashes removing the grasp of the glue. 

In most cases, removal of superglue to the lashes or eyelids isn't so simple. Frankly, it can be a sticky mess. Fortunately, superglue will come off on its own...eventually. Applying an opthalmic ointment to the area then covering it with a gauzy patch is the best approach. The opthalmic ointment can safely be applied to eyes and the oily consistency helps break the bonds of the glue more quickly. If you have limited resources, or consider yourself to be MacGuyver, you can sub margarine for opthalmic ointment. With application of an oily substance, the adhesive will gradually lose strength and the lashes will separate on their own in 1-4 days. Wearing a patch is important for comfort and to keep the eye moist and lubricated. 

Glue Adhered to the Surface of the Eye Itself

Most often when superglue is mistaken for eye drops the individual blinks immediately on instillation as glue causes burning. With blinking, the adhesive is pushed to the lashes and lid margins. However, glue can occasionally adhere to the eye itself, attaching itself to proteins on the eye's surface. This can cause blurred vision and tearing.

In cases where glue enters and adheres to the eye, rinse the affected eye with water as this may dissociate some of the glue from the surface of the eye. Then, examen the eye with flourescein stain. While the glue itself with detach itself from the eye naturally, usually within a few hours (never try to pull it off), many people sustain a concomitant corneal abrasion by rubbing the irritated area. 

Corneal Abrasion

While glue will not damage the eye permanently, it will simply cause short-term irritation, many individuals sustain associated eye injury as a result of rubbing or scratching at the irritated eye. As with any eye injury, examen the affected eye with fluorescein stain looking for a corneal abrasion. If one is noted, treat the injury by prescribing prophylactic antibiotic drops or ointment and pain medication if necessary. If the eye does not heal within one or two days, or the injury if significant, referral to an ophthalmologist may be warranted. 

Have you treated any superglue-related injuries in your practice?

 

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Comments

this just happen to my 3-year-old son and I feel like the worst mom ever. He has had his eye shut for 5 days now and if he doesn't open by Friday he will be put to sleep so they can open it since he won't even let the eye doc touch it. I'm freaking out his everywhere I read about these accidents the eye has open from 1 to 4 days. I'm getting very worried and going crazy. he is on erythromycin ophthalmic ointment and some systane balance drops and his eye has been watering more. has this happen to any parent out !

carolina

Well, once i was working with super goue and it was not grtting out. So i started to shake it and it went on my cheeks and nose and my right eye. It stuck my eyelids together and when i blinked it opened. I guess im superman

SketchYT

How do i get rid of the swelling? its been 3 days and still is painful

Rabbit

Referral to an opthalmologist should be made regardless. The potential implications for not doing so come with serious consequences. If I were the patient (or supervising physician) in your practice, I would be concerned about your judgement if an opthalmic consult or referral were not requested/made. The gung-ho attitude of "I've got this" endangers patients, and perpetuates the questions of judgment and competency of NP's. A family practice MD would follow treatment protocol and insist upon a follow up with the specialist. This covers everyone. The client and the physician/provider are protected in this scenario. Excitement about a "case" and being almost giddy about getting to treat it...that's a sign of immaturity. Patient first. Period. There is nothing exciting or interesting about going blind or being sued.

LucyJ.

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