How should a subcutaneous tick in eyelashes be treated? - briefly
Remove the tick with fine sterile forceps, ensuring the entire mouthpart is extracted, then apply a topical antibiotic ointment and observe for signs of infection. If removal is challenging or inflammation occurs, obtain prompt ophthalmologic evaluation.
How should a subcutaneous tick in eyelashes be treated? - in detail
A tick lodged beneath the eyelash margin requires prompt, sterile removal to prevent infection and ocular damage.
The procedure begins with thorough hand hygiene and the use of sterile gloves. Topical anesthetic drops (e.g., proparacaine 0.5 %) are instilled to minimize discomfort and reduce reflex blinking. Under a magnifying loupe or operating microscope, fine, straight forceps (e.g., jeweler’s forceps) are positioned as close to the tick’s head as possible. A steady, upward traction is applied to extract the organism in one motion, avoiding squeezing the body, which could cause regurgitation of saliva and increase toxin exposure.
If the tick’s mouthparts remain embedded, a sterile cotton swab soaked in 70 % isopropyl alcohol can be applied to the area for several seconds, then the residual parts are gently coaxed out with the forceps. After removal, the ocular surface is irrigated with balanced salt solution to flush debris.
Post‑extraction care includes:
- Application of a broad‑spectrum ophthalmic antibiotic ointment (e.g., erythromycin 0.5 %) three times daily for 5‑7 days.
- Prescription of a short course of oral doxycycline (100 mg twice daily for 7 days) when the tick species is known to transmit Borrelia or when regional tick‑borne disease prevalence is high.
- Monitoring for signs of conjunctivitis, keratitis, or uveitis; any worsening redness, pain, photophobia, or visual change warrants immediate referral to an ophthalmologist.
- Documentation of the tick’s appearance and, if possible, submission of the specimen to a laboratory for species identification and pathogen testing.
Follow‑up examination within 48 hours confirms complete removal and assesses for secondary infection. Patients should be instructed to avoid rubbing the eye and to keep the area clean, using sterile saline drops as needed for lubrication.