[Question #5635] Eyes

20 months ago
Hi Docs,

Hoped I didn't need to return but seeking some guidance going forward. Various incidents and waiting for negative tests over the years has given me an irrational fear of blood born viruses. I have a particular phobia of someone's blood hitting my eyes as it's sort of something out of my control. I go to CBT therapy which is currently ongoing weekly.  Sometimes  I rub my eye with a pocket tissue as I am hyper aware of sensations and check to see if blood has hit it (crazy I know), but a compulsion nonetheless 

Anyway today at the gym I had been exercising around others and felt something in my eye. Low and behold I rub it with a tissue and see what looked like eye discharge (those gooey white substances?) Mixed with blood. My eye was not actively bleeding after when I checked and hours on seems fine, just irritated and red. Funny thing is I don't know where this came from and worry it came from somebody else who was training around me? Making contact with the mucus membrane. It's a busy gym and I don't really inspect those around me.  Would this be of any concern for hiv/hep c? I'm vaccinated against B. 

My only other question is what advice would you have for someone like me in therapy but worried about contracting something like hiv through eye exposures in public places. Is it just as ludicrous as it sounds? I'd always gone by no unprotected sex/iv drug use = no hiv risk but things like today through that into the air. 
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
Welcome to the Forum and thanks for your question.  I am impressed with the insight you have to your problem and am pleased that you are working to address it with a trained therapist - this is your most important way forward.  As you already acknowledge, you do not know where the material you saw on the tissue came from and statistically it is more likely to have been from your own body than from someone else.  Had it come from someone else, the irritation would have been more sever than yours seems to be and elicited more of a response (blinking, watery of the eyes, etc.). Perhaps it will be helpful to remind you that while exposure to the environment and all of its hazards, eye infections occurring from direct inoculation are extraordinarily rare.  The eye has liquid and epithelial barriers to infection and is protected by the blink reflex which acts to remove external things that contact the eye. The blink reflex is remarkably fast and as such is a major additional barrier to infection.  Combined, these multiple barriers to infection make external eye infections vanishingly rare(most eye infections occur due to spread within the body).  I am unaware of anyone who has ever caught HIV or hepatitis through the sort of exposure you describe and am confident that I would be aware of it if it were a meaningful risk.  I urge you to continue your therapy and do your best not to worry.  I see no reason for concern and certainly no reason for testing related to the event you describe.

I hope my comments are helpful.  EWH 
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