How should a subcutaneous tick on the eyelids be treated? - briefly
Use sterile fine‑point forceps to grasp the tick as close to the skin as possible and extract it in a steady, upward motion, then clean the area with antiseptic solution and apply a topical antibiotic ointment; observe for signs of inflammation or infection and seek ophthalmologic evaluation if symptoms develop.
How should a subcutaneous tick on the eyelids be treated? - in detail
A tick lodged beneath the skin of the eyelid requires prompt, sterile removal to prevent infection and toxin transmission.
Initial assessment includes visual inspection, magnification, and documentation of the tick’s location, size, and attachment duration. If the patient reports systemic symptoms (fever, rash, headache) or the tick is engorged, systemic evaluation and possible prophylactic antibiotics should be considered.
Removal procedure
- Prepare a sterile field; apply a topical anesthetic (e.g., 0.5 % proparacaine) to the ocular surface and surrounding skin.
- Using fine‑point forceps (tweezers with serrated tips), grasp the tick as close to the mouthparts as possible.
- Apply steady, gentle traction upward, avoiding twisting or crushing the body, which could leave mouthparts embedded.
- After extraction, inspect the site for residual parts; if any remain, repeat the procedure with a smaller instrument or consider surgical excision under local anesthesia.
Post‑removal care
- Irrigate the area with sterile saline, then apply a thin layer of broad‑spectrum ophthalmic antibiotic ointment (e.g., chloramphenicol 0.5 %).
- Cover with a sterile dressing if bleeding occurs; otherwise, leave uncovered to monitor for inflammation.
- Advise the patient to observe for signs of infection (increased redness, swelling, purulent discharge) or allergic reaction (urticaria, pruritus) for 48–72 hours.
Follow‑up
- Schedule a review within 24 hours to assess wound healing.
- If systemic symptoms develop, initiate appropriate antimicrobial therapy based on regional tick‑borne disease prevalence (e.g., doxycycline for Lyme disease or rickettsial infections).
Precautions
- Do not apply petroleum‑based substances, heat, or chemicals to force detachment; these methods increase the risk of pathogen transmission.
- Ensure that all instruments are sterilized before use to prevent secondary ocular infection.
By adhering to sterile technique, precise extraction, and vigilant post‑procedural monitoring, complications such as cellulitis, keratitis, or systemic tick‑borne disease can be minimized.