This Halloween, Goggles for All

• By James Lee, M.D.
• October 17, 2017

I liked dressing up for Halloween, but I loved the candy. Every house my family hit got a mental grade based on the type of candy scored. A Jolly Rancher would be a “C,” a tiny Mr. Goodbar a “B” and any Snickers a solid “A+.” But there was always that house, that sad house, continuously deflating the hopes of excited children with a neon green toothbrush. Give yourself a failing grade, Mr. Too Good for Twix.

All grown up, and now an ophthalmologist, I would actually dearly love to hand out something else besides candy to every family stopping by our house. Not to the little ones, mind you – they’re still getting well-earned Snickers.  Everybody else, however, will be receiving a lovely pair of safety goggles. We aren’t talking the slick looking Bono style glasses that barely cover your eyes. I mean true goggles, suctioned on to your face 360 degrees around those cherished eyeballs. 

Yes, they are terribly unsightly. Nobody looks good in them, except my wife. However, I have taken care of countless patients in the emergency room who would give anything to go back in time and throw on a pair. You never think it’s going to be you – but every once in a while, you are the unlucky soul. I have seen so many completely preventable eye injuries from mowing the grass, automobile work (more often than you think), woodworking, welding, metal grinding and many other high-risk activities. Half of the time, the patients I see were not wearing eye protection at all. However, the other half of the time, these poor patients were wearing safety glasses. Despite trying to appropriately protect their eyes, there is a chunk of metal lodged in their cornea all the same.

The simple fact is that safety glasses are insufficient to protect your eyes when performing any activity where small particles might become high-velocity projectiles. Working with metal, wood or a car, tractor or mower qualifies. It seems impossible. How on earth could a piece of wood magically travel around the edges of your glasses during a quick buzz of the saw? I have had patients show me their safety glasses, swearing that no chip of wood could abide by the laws of physics and still reach their eyeball. Please, please, please let me save you the trouble. That chip of wood can do it. I myself am honestly not sure how. I just know it can.   

Now here are the scare tactics. The best-case scenario is you end up with a corneal abrasion, or a scrape on the front of the eyeball. I promise, it is even more painful than it sounds. Plus, unlike scraping your skin, the worst of the pain often lasts a couple of days instead of a couple minutes. If any foreign object lodges in the cornea (the clear dome over the colored part of your eye), then it will have to be removed at a microscope. That involves sitting extremely still while I carefully dig it out with a needle. But wait, why does the eye doctor have a drill? If you are unfortunate enough to have had a metal object lodge in the cornea, it often creates a ring of rust, which needs to be removed as well. That’s where the drill comes in. Yes, we do numb the eye for these procedures, but still, this is not how you want to spend your Saturday. Next, any abrasion or foreign body could lead to a deep infection, requiring strong antibiotics and possibly leading to permanent vision loss. All foreign bodies leave behind scars, which depending on the location, also can cause permanently blurred vision. Finally, if the particle is sharp enough or has enough velocity, it could bust through the wall of the eye requiring emergent surgery and certainly risks severe permanent vision loss. 

Save the safety glasses for racquetball. They are great for stopping large rubber balls!  But if you are out in the yard, working on your car or even thinking about grinding metal, please wear safety goggles with 360-degree protection. If you find my house on Halloween, you might even get a pair for free.

James Lee, M.D., is a physician at Texas Tech Physicians – Eye Clinic and an assistant professor at the Department of Ophthalmology at the Texas Tech University Health Sciences Center.