Alger Brush To Effectively Clean The Eyes
Accidents may happen and metallic fragments may enter the eye and lodge itself in the cornea. This is the eye’s thick outermost layer located in the front portion. The cornea serves as a protective barrier against foreign materials that may damage the inner eye region. Metallic fragments may become embedded in the cornea. When these fragments are removed, they may leave rust particles or rust rings behind. These are a result of the chemical reaction between the metallic fragment and the natural moisture of the eyes. These rust rings can cause future eye damage and problems. To remove the rust materials from the cornea, a corneal drill is used. Another way to do so is by using a corneal brush, which removes rust rings gentler than corneal drills. The most commonly used corneal brush is the alger brush.
What is an alger brush?
An alger brush is specifically designed for removing rust rings on the corneal surface. It has a burr attached to a rotating instrument, which has a motor with very low torque. The motor utilizes a centrifugal force that rotates the burrs in a slow and well-controlled manner. It removes the rust ring by brushing of the corneal surface until all rust rings are removed. In this way, the corneal surface is left smooth, which facilitates healing faster and without any residual damage.
The alger brush has burrs that are blunt, to avoid further damage or scratching of the corneal surface. The motor is designed to automatically stop rotating once the burrs touch the basement membrane of the cornea.
How to remove the rust rings
Put a drop of local anesthetics on the affected eye. Have the patient keep the eye fully open, while focusing on an object. Position the line of sight in a way that the area of injury becomes most accessible for the removal of the rust rings. To apply the alger brush, approach the eye from the sides, in a tangential manner, rather directly (perpendicularly) on the eye surface. Place the tip of the brush over the discolored portion of the cornea, directly over the rust rings. Press the rotating brush over it. The brush automatically stops if it is pressed in too deep. The rotating burrs removes or brushes off the damaged corneal epithelium. Continue using the brush until all the discoloration within the damaged area is gone. Limit the use of the alger brush over a small area, preferably only until the edges of the discolored and damaged corneal epithelium.
After the alger brush has removed all the damaged corneal epithelium, instill a drop of sodium flourescein to check for the damage. Typically, antibiotic drops are given for about 5 days after cleansing. There may still be a bit of staining after the brushing, but there is no need for further brushing. It will eventually go away on its own. Talk to the patient to allay anxiety during the entire process. Have an assistant ready to pull the upper eyelids open in the event that the patient cannot keep the eyes open for the entire process.
Examples of Alger Brushes
