First aid - Eye Injury:
The eye is a delicate structure that is easily damaged by a small foreign body. If a foreign body scratches or scars the eye surface, the patient may lose some or all vision in the injured eye. Eye protection should always be worn when particles or fluid could enter the eye.
Even a minor eye injury can cause serious, lifelong eye damage. For example, bleeding within the eye, caused by an eye injury, can cause glaucoma later in life. Eye injuries can cause loss of vision, or complete loss of an eye. Listed below is information about first aid treatment in the event of an eye injury.
A heavy blow may injure soft issues and bone around the eye. This can result in pressure on the eyeball and cause blurred or double vision, or even blindness. In a workplace where welding is undertaken a painful flash injury may occur unless personal protective equipment is used correctly.
A chemical splash in the eye can cause permanent loss of vision and needs prompt first aid and medical care.
Symptoms and signs:
- Chemical exposure: The most common symptoms are pain or intense burning. The eye will begin to tear profusely, may become red, and the eyelids may become swollen.
- Subconjunctival hemorrhage (bleeding): Generally, this condition by itself is painless. Vision is not affected. The eye will have a red spot of blood on the sclera (the white part of the eye). This occurs when there is a rupture of a small blood vessel on the surface of the eye. The area of redness may be fairly large, and its appearance is sometimes alarming. Spontaneous subconjunctival hemorrhages may occur in the absence of any known trauma. If it is unassociated with other signs of trauma, it is not dangerous and generally goes away over a period of 4 to 10 days with no treatment.
- Corneal abrasions: Symptoms include pain, a sensation that something is in the eye, tearing, and sensitivity to light.
- Iritis: Pain and light sensitivity are common. The pain may be described as a deep ache in and around the eye. Sometimes, excessive tearing is seen.
- Hyphema: Pain and blurred vision are the main symptoms.
- Orbital blowout fracture: Symptoms include pain, especially with movement of the eyes; double vision that disappears when one eye is covered; and eyelid swelling which may worsen after nose blowing. Swelling around the eye and bruising often occur. A black eye is the result of blood pooling in the eyelids. This can take weeks to disappear totally.
- Conjunctival lacerations: Symptoms include pain, redness, and a sensation that something is in the eye.
- Lacerations to the cornea and the sclera: Symptoms include decreased vision and pain.
- Ultraviolet keratitis: Symptoms include pain, light sensitivity, redness, and a feeling that something is in the eye. Symptoms do not appear immediately after ultraviolet exposure but rather about 4 hours later.
- Solar retinopathy: Decreased vision with a small area of central blurring is the primary symptom.
- Corneal: A sensation that something is in the eye, tearing, blurred vision, and light sensitivity are all common symptoms. Sometimes, the foreign body can be seen on the cornea. If the foreign body is metal, a rust ring or rust stain can occur.
- Intraorbital: Symptoms, such as decreased vision, pain, and double vision, usually develop hours to days after the injury. Sometimes, no symptoms develop.
- Intraocular: People may have eye pain and decreased vision, but, initially, if the foreign body is small and was introduced into the eye at high velocity, people may have no symptoms.
Eye Injuries Causes
- Chemical exposures and burns: A chemical burn can occur in a number of ways but is most often the result of a liquid splashing into the eye. Many chemicals, such as soap, sunscreen, and even tear gas, are primarily irritants to the eye and do not usually cause permanent damage. However, acids and alkalis are highly caustic and may cause severe and permanent damage to the ocular surface.
- Acids (such as sulfuric acid found in car batteries) or alkaline substances (such as lye found in drain cleaner and ammonia) can splash into the eyes.
- Rubbing the eye can transfer chemicals from the skin on the hands to the eye.
- Aerosol exposure is another method of potential chemical injury and includes such substances as Mace, tear gas, pepper spray, or hairspray.
- Subconjunctival hemorrhage (bleeding): This is a collection of blood lying on the surface of the white of the eye (sclera). It is contained by the conjunctiva, which is the membrane that lies over the sclera. Subconjunctival hemorrhage may accompany any eye injury. The degree of subconjunctival hemorrhage is not necessarily related to the severity of the injury.
- Corneal abrasions: The cornea is the transparent tissue that is located in front of the pupil and iris. A corneal abrasion is a scratch or a traumatic defect in the surface of the cornea. People with corneal abrasions often report that they were "poked" in the eye by a toy, a metallic object, a toddler's fingernail, or a tree branch.
- Traumatic iritis: This type of injury can occur in the same way as a corneal abrasion but is more often a result of a blunt blow to the eye, such as from a fist a club, or an air bag in a car. The iris is the colored part of the eye. It contains muscles that control the amount of light that enters the eye through the pupil. Iritis simply means that the iris is inflamed.
- Hyphemas and orbital blowout fractures: These injuries are associated with significant force from a blunt object to the eye and surrounding structures. Examples would be getting hit in the face with a baseball or getting kicked in the face.
- Hyphemas are the result of bleeding in the eye that occurs in the front part of the eye, called the anterior chamber. This is the space between the cornea and the iris. The anterior chamber is normally filled with clear fluid, called the aqueous fluid.
- Orbital fractures are breaks of the facial bones surrounding the eye. An orbital blowout fracture is a break in the thin bone that forms the floor of the orbit and supports the eye.
- Lacerations (cuts) to the eyelids or conjunctiva (the clear covering over the white of the eye): These injuries commonly occur from sharp objects but can also occur from a fall.
- Lacerations to the cornea and the sclera: These injuries are very serious and are frequently associated with trauma from sharp objects.
Foreign bodies in the eye: Generally, a foreign body is a small piece of metal, wood, or plastic.
- Corneal foreign bodies are embedded in the cornea and have not penetrated the eye itself. Iron containing metal foreign bodies in the cornea can cause a rusty stain in the cornea, which also requires treatment.
- Intraorbital foreign bodies are located in the orbit (or eye socket) but have not penetrated the eye.
- Intraocular foreign bodies are injuries in which the outer wall of the eye has been penetrated by the object.
- Ultraviolet keratitis (or corneal flash burn): The most common light-induced trauma to the eye is ultraviolet keratitis, which can be thought of as a sunburn to the cornea. Common sources of damaging ultraviolet (UV) light arc welding arcs, tanning booths, and sunlight reflected by snow or water, especially at higher altitudes where UV rays are more intense or by light reflected by snow or water.
- Solar retinopathy: Damage to the central part of the retina can occur by staring at the sun. Common situations that may cause this are viewing solar eclipses or drug-induced states where the person looks at the sun for an extended period of time.
Major eye conditions
1. Rest and reassure the patient
- Tell the patient not to roll their eye.
- Help the patient to rest in the position of greatest comfort with the injured eye closed.
- If the eye injury is caused by a chemical splash, flush the eye with copious amounts of water.
- Advise the patient to avoid all movement of the head to prevent further eye damage.
- Reassure the patient.
Protect the injured eye:
- Cover the injured eye with a clean eye pad or wound dressing. If there is a large foreign body lodged in the eye, DO NOT attempt to remove it, but pad around the eye socket to avoid pressure.
- Advise the patient to keep the uninjured eye closed if possible to reduce the risk of movement of the injured eye.
Arrange for medical care
- Continue to give reassurance and encouragement to the patient.
- While waiting for the ambulance to arrive, check the patient for any other injuries, particularly if a blow or fall was involved.
- Check the level of consciousness and ensure that the airway is clear.
- Remember that an injury around the eye may be associated with a head injury.
Minor eye conditions:
1. Removal of a foreign body
- Tell the patient not to rub the eye.
- Check whether the foreign material is visible on the white part of the eye.
- Ask the patient to blink several times to try to remove the foreign body by washing it out with tears.
If the object is not removed after several attempts, DO NOT continue because of the risk of scratching the eye surface and causing scarring.
If the foreign object cannot be seen clearly or is over the coloured part of the eye, DO NOT try to remove it.
2. If unsuccessful, the foreign body may not be removed by gentle flushing of the affected eye
- Use a clean jug filled with water and pour a stream of fluid across the injured eye and into a bowl or handbasin. Pour the fluid from the mnose end of the eye toward the outer corner to avoid accidentally flushing the uninjured eye. Tilt head to injured side to aid flushing.
- If unsuccessful, cover the eye with a clean pad and see a doctor.
Snow blindness / welder’s flash:
Excessive glare (or bright light from a welder) can damage eyes. The patient may complain of severe pain in the eye(s), with a ‘gritty’ feeling. The eye may be sensitive to light and may be watery and/or red.
First aid for different eye injury:
Any kind of injury or trauma to the eyes should be taken seriously. Prompt medical attention for eye problems can save your vision and prevent further complications.
Chemicals common at home or in the workplace can easily get splashed into your eyes. It is important to wear safety glasses when handling toxic or abrasive chemicals, and to use caution with household cleaners in order to prevent injury.
First aid care for chemical burns includes:
- Encourage the person to remain calm and keep his or her eyes open until they can be flushed. Closing the eyes traps the chemical in and does further damage.
- Flush eyes generously with water for 15 to 20 minutes. Make sure the person keeps their eyes open during flushing.
- Get immediate medical care.
You can also call your local poison center for instructions. Be prepared to give information about the name and type of chemical, if possible.
The eye often cleans itself of debris with tearing, so no treatment is needed until you are certain the object cannot be removed by itself.
First aid care for foreign objects in the eyes includes:
- Prevent the person from rubbing their eyes.
- Have him or her lift the upper eyelid up and out over the lower lid. Then have the person roll their eyes around.
- Flush the eyes generously with water. Have the person keep eyes open during flushing.
- Repeat the previous steps until the object is eliminated.
- Follow up with a doctor to make sure all debris is gone and the eyes have not been scratched or damaged.
If there is an object embedded in the eye, do NOT remove, as this may cause further damage. Instead, cover the eye with an eye shield or gauze and seek prompt medical attention.
Blows to the Eye:
Sudden strikes from objects or humans can hit the eye directly or around the socket. Minor blows can often be managed at home; however any eye injury should be monitored for signs of a more serious injury or potential infection.
First aid care for a blow to the eyes includes:
- Gently place a cold compress over the eye in five to 10 minute intervals. Do not place ice directly on skin; use a cloth in between the ice and skin.
- Call your doctor. He or she may want to examine the eye for potential damage.
- After 24 hours, switch to warm compresses. This will help with bruising.
Seek immediate medical attention if you notice any of the following symptoms:
- Drainage from the affected eye
- Vision changes
- Persistent pain
- Any visible abnormalities or bleeding in the sclera (white part) of the eye
Cuts or puncture wounds of the eye or lid:
You should seek immediate medical care if you suffer this type of injury. However, you need to follow some basic first aid steps to ensure proper safety and support.
First aid care for cuts or punctures includes:
- Do not wash the eye or lid.
- If there is an object embedded in the eye, do NOT remove. You may do further damage.
- Cover the eye with an eye shield, or if not available, the bottom half of a paper cup. Tape the shield gently over eye to secure on the face.
- Seek prompt medical attention.