Eye Injury

Question
Mike,

This past weekend, my girlfriend & I went diving in Catalina, California (right off the Casino on the island if you're familiar).
We were with an instructor, no more than 30-40 feet down, and my girlfriend had problems equalizing. We'd come back up, and her she'd had rings around her eyes, resembling a racoon.
The dive instructor took her out of the water, and she was done. While out, the broken blood vessels in her inside corners/bottoms of eye had become bright red, almost ripe tomato.

We'd kept ice packs on the eyes for the rest of the night, the swelling went down, and it's now almost six days later, the outsides look okay, but we still have the red broken blood vessels. At what point do you think we should be seeing the doctor?


Also, while getting out of the water, our instructor showed another instructor and he said it was the worst he'd personally ever seen....but no one really said what to do about it...

Any advice is helpful,
Tim

Answer
Hi Tim,

I'm very sorry to hear of your girlfriend's eye problems.  From what you've told me, I suspect that she had a severe mask squeeze.  As we descend, the increasing water pressure will force the mask against the face. This pressure is normally equalized by occasionally exhaling through the nose and into the mask, allowing the mask to resume it's normal position and volume.  If the pressure isn't equalized then the mask will remain squashed against the face and a vacuum will occur as the diver moves to a shallower depth. A mask squeeze is the result.  The action of this vacuum against the skin and eyes is similar to the "hickey" that you are probably already familiar with.  You indicated that your girlfriend had problems with equalizing and that could certainly lead to problems with a mask squeeze.  Typical signs of a mask squeeze are the "raccoon eyes" you mentioned as well as broken blood vessels in the whites of the eyes (subconjunctival hemorrhage).  As long as vision isn't affected, these signs will normally resolve themselves.  They are both caused by blood being forced out of blood vessels and into surrounding tissue. The body will gradually reabsorb this blood and the discoloration will disappear.  However, I am not a doctor so I'm not giving you medical advice.  You should have seen your eye doctor ASAP. I think it would be prudent to see him as soon as possible for a vision evaluation and to make certain that no additional problems such as conjunctivitis have been caused by this hyperbaric incident.

It's interesting to note that you can create a mask squeeze by pressing the mask close to your face with your hand and then releasing it.  The vacuum you feel is what causes the mask squeeze.  When it is done at depth, the resulting vacuum can be much stronger so be sure to equalize it quickly!!

I hope this information helps.

Mike Giles
Mike's Dive Center
mikescuba.com