Tick In Eye
Eight-year-old Brianna Adams is recovering at home in New Market after having a tick extracted from her left eye Tuesday evening at the Wilmer Eye Institute of Johns Hopkins Hospital in Baltimore.Dr. Dan Paskowitz, the ophthalmologist who removed the bloodsucking arachnid, said a tick making its way into someone's eye is rare.
"I've never seen or heard of this happening before," he said.
A few such cases do exist in medical literature, he said.
Fortunately for Brianna, the procedure to remove the tick is routine. That's probably why few such cases are reported, Paskowitz said.
Brianna's mother, Christina Beachner, noticed the tick when Brianna came home from school Monday afternoon and was rubbing her eye, saying it itched. Beachner looked at her daughter's eye and noticed a tick was embedded in the cornea.
Beachner took her daughter to FrederickMemorial Hospital, but then decided Brianna needed to be seen by an ophthalmologist. She went to Kids Eye Care in Frederick on Tuesday morning, and was referred to the Wilmer Eye Institute. Surgery was set for 7 p.m. Tuesday.
The Wilmer Eye Institute is one of a handful of hospitals in the country that has an ophthalmologist available around the clock.
In the meantime, Brianna's tick crawled beneath her lower eyelid and became 60 percent embedded. Beachner said doctors told her it is unusual for a tick to crawl into the eye because ticks prefer dry environments.
"We don't know how it got there," she said.
Brianna was put under light sedation by an anesthesiologist. Dr. David Ramsey, who assisted Paskowitz in the surgery, spread Brianna's eyelids apart, giving the two doctors a good view of the insect. Paskowitz then grabbed the tick by its legs using metal forceps, and pulled it out of Brianna's eye. The whole procedure took about 15 minutes.
The doctors made sure no part of the tick was left behind. The tick was in the fornix, the space between the eyeball and the eyelid, off to the side of Brianna's eye, near her temple. It was buried in the conjunctiva, a membrane. A tick feeds on blood, and the conjunctiva has a lot of blood, Paskowitz said.
Brianna and her mother were home before midnight that night.
"They put a little slit in the eye and the tick came out," Beachner said.
Brianna was running around Wednesday.
"Kids bounce back," Beachner said. "Her eye's a little swollen."
Brianna and Beachner arrived at the Baltimore hospital about 1 p.m. Tuesday, and a social worker stayed with Brianna most of the day. Beachner praised the social worker, who kept her daughter entertained.
Brianna was brave throughout the procedure, Paskowitz said.
"She did ask to have the tick so she can show it to her friends at school," he said.
Brianna is in third grade at Deer Crossing Elementary School, and her mother thinks she might have picked up the tick on the playground. Paskowitz does not think it is a deer tick. Deer ticks carry Lyme disease. Just in case, Beachner said Brianna will be watched for symptoms of Lyme disease.
Brianna has the tick in a jar, a little souvenir of her medical adventure.
Beachner and her husband, Kurt, have four children. Brianna is the oldest.
Photo by Graham Cullen
Brianna Adams, 8, peers into a plastic case containing a tick that was removed from her left eye Tuesday at the Wilmer Eye Institute of Johns Hopkins Hospital in Baltimore.