Since the bottles looked similar at a glance, and the nicotine-laced
liquid carried no warnings about the harm of contact with the eyes,
the authors of a case report in JAMA Ophthalmology say e-cigarette
users should be aware of this risk.
The researchers describe a patient in her 50s who presented to the
Tennent Institute of Ophthalmology at Gartnavel General Hospital in
Glasgow with eye irritation. She had recently been prescribed
antibiotic drops for bacterial conjunctivitis, or pinkeye, and
stored these next to her e-cig refill liquid in her bathroom
cupboard.
When she mistakenly dripped e-cig liquid in her eye she immediately
experienced pain, redness and blurred vision. She flushed the eye
with water and went to emergency eye services. According to chemical
tests, her e-cig liquid had a pH of 6, more acidic than tears, which
usually have a pH of about 7.0 to 7.3.
By the time the woman was tested in the hospital, her eye pH was
7.0, which the doctors credited to her having rinsed her eye
immediately. Her cornea was stained but there was no damage to the
delicate epithelial cells of the eye.
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The researchers did not find any other reported cases of people
putting e-cigarette liquid in their eyes, but there have been
similar accidents with nail glue or olbas oil, which is used to
remedy nasal congestion, they write.
“There have been increasing reports of severe ocular injury
(including globe rupture) from e-cigarette explosions, both in the
eye literature and in the mainstream media,” said coauthor David
Lockington of Gartnavel General Hospital. “As far as we know,
inadvertent administration of E-Cig liquid to the eye instead of
eyedrops has not been previously reported in the ophthalmic
journals,” he said by email.
In this case, the patient only experienced superficial ocular
surface damage, which resolved with treatment, he said.
“Our patient had a good outcome from this unfortunate incident, with
no long term damage to her ocular surface or vision, because she
immediately washed out her eye as soon as she realized her mistake,
and so limited the potential damage,” Lockington said.
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Emergency management of any chemical injury to the eye is immediate
irrigation and to seek help, he said.
“This is a disturbing report, and it is fortunate that it happened
in a bathroom where she had access to running water,” said
biochemist Irina Stepanov of Masonic Cancer Center at the University
of Minnesota in Minneapolis, who was not involved in the report.
Though the similarly shaped bottles were misleading, regardless of
their shape, medical products like antibiotic drops should be stored
away from any potentially similar products like nail glue,
Lockington said.
“There is no warning information on the side of these e-cig liquid
bottles or in the product information regarding the potential danger
of a chemical injury to the eyes, or the emergency treatment,” he
said. “This is an oversight which should be addressed by the
industry.”
SOURCE: http://bit.ly/2eNbA1c JAMA Ophthalmology, online October 13,
2016.
(This story corrects to add dropped letter "h" in journal title in
paragraph 2.)
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