Written by: Alan Mendelsohn, M.D.
I had a very meticulous 60-year old with glaucoma who was exceedingly conscientious with using her glaucoma eye drops twice per day. She always told me that she loved to develop precise schedules for instilling the drops after breakfast and after dinner, while sitting at her desk. She would sit in her chair, tilt her head way back, look up to the ceiling and gently squeeze the bottle from about four inches above her right eye. Immediately thereafter, she would repeat the process with her left eye.
One evening I received an emergency phone call from a relative of hers – both my patient and her relative were in a panic. The relative blurted out that something terrible occurred and inexplicably my patient was totally blinded by the eye drops, unable to see anything at all. I requested that they meet me IMMEDIATELY at the office, but I did instruct for them to bring all the eye drops that we present on the desk with them.
I arrived at the office within five minutes with my mind racing 100 mph, petrified, wondering what could she have placed into her eyes to blind both of them almost instantaneously? Could have the drops been tainted? Did she accidentally place a solution into her eyes that is toxic? But, if this were the case, she would have inflammation and swelling of the cornea, resulting in markedly reduced vision, but certainly not blindness.
I had taken care of this patient for a decade and knew that she was not an exaggerator and always extremely precise with everything that she said and did. How in the world could she have sudden blindness from her eye drops?
The family brought my patient into the office, escorting her as if she were totally blind, holding onto both of her arms and guiding her. My heart sank. We proceeded to an exam room. I asked her to read the chart to ascertain her level of vision. Sobbing uncontrollably she blurted out, “I see nothing. Absolutely nothing. It’s pitch black. Oh dear God.” However, her eyelids were shut all the way and I calmly said, “Sweetheart, your eyelids are closed, please open them up as wide as possible so that I can get a look and see what is going on.”
She could NOT open up her eyelids. They were glued shut. Totally sealed. Worse yet, when I asked her to look up, down, to the right, and to the left, feeling for movement under her eyelids, it was obvious that both eyeballs were totally stuck to her eyelids and there was no eye movement at all. Now, it was my turn to say, “Oh dear God.” I knew that inadvertently she had instilled one drop of glue, into both eyes, instead of her eye drops. I asked the family to see all the drops that they brought with them and one of the drops was cyanoacrylate, an extremely fast acting and an extremely effective adhesive.
It turns out that after dinner, as a past time, my patient would meticulously build models, using her cyanoacrylate for the projects. The adhesive was in a bottle in a very similar size and configuration to the glaucoma drops. Yikes! She was working on the model when it was time to place her glaucoma drops. She took “the bottle” (obviously the WRONG bottle), tilted her head back, and at point blank range, instilled a drop of cyanoacrylate into her right eye and left eye in immediate succession. Guess what? The adhesive worked beautifully on human tissue, causing the upper and lower eyelids to be sealed shut, with the eyeball underneath being totally immobile.
Utilizing topical anesthetic and extremely sharp micro surgical scissors, I was able to separate her eyelids. Thereafter, with lots of anesthetic drops, Q-tips, rounded forceps, and gentle pressure, I was able to free up the eyeball and remove residual glue. Each eye took at least 30 minutes. (Ironically, advanced laser cataract surgery takes only five minutes per eye in comparison).
After an hour of proceeding with baby steps, lysing (breaking) all adhesions, she returned to perfect 20/20 vision in both eyes and full function of her eye lids and eyes! My reward was a big hug and kiss from a very relieved sweetheart who had an emotionally exhausting evening.