How to Handle Common Eye Injuries
Some common eye injuries, such as deep puncture wounds from accidents, could require immediate treatment or surgery to prevent permanent eye damage resulting in vision loss.
This guide to common eye injuries can help you determine your next step following an accident, especially if you are in an emergency situation. Remember also that common sense safety precautions such as wearing safety goggles or glasses may be your best approach to preventing eye injuries altogether and maintaining healthy vision for a lifetime.
Common conditions associated with eye injury and trauma include:
Scratched Eye (Corneal Abrasion)
Common causes of abrasions to the eye's surface (corneal abrasions) are getting poked in the eye or rubbing the eye when a foreign body is present, such as dust or sand. Corneal abrasions are very uncomfortable and cause eye redness and severe sensitivity to light.
Eye lacerations usually require emergency care. Don't hesitate to visit an eye doctor immediately.
If you know something has scratched your eye, it's very important to see your eye doctor or an emergency room/urgent care center to seek treatment for your eye injury.
Scratches also can make your eye susceptible to infection from bacteria or a fungus. Certain types of bacteria and fungi can enter the eye through a scratch and cause serious harm in as little as 24 hours. Even blindness can result. This is especially true if whatever scratched your eye is dirty or contaminated.
Remember also that infections from eye injuries such as scratches can originate from unexpected sources such as a baby's fingernails or tree branches.
If you have a scratched eye, don't rub it. And don't patch your eye, either. Bacteria like dark, warm places to grow, and a patch might provide the ideal environment. Simply keep the eye closed or loosely tape a paper cup or eye shield over it. See your doctor as soon as possible to check out this type of eye injury.
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Penetrating or Foreign Objects in the Eye
If a foreign object such as metal or a fish hook penetrates your eye, visit the emergency room/urgent care center right away. You could cause even more injury to your eye if you attempt to remove the object yourself or if you rub your eye.
If possible, try loosely taping a paper cup or eye shield over your eye for protection; then seek help.
Your eye also may have corneal foreign bodies that are small, sharp pieces of a substance (usually metal) that have become embedded in the eye's surface (cornea), but have not penetrated into the interior of the eye.
Metal foreign bodies can quickly form a rust ring and a significant scar. Your eye doctor should remove these foreign bodies as soon as possible.
Caustic Foreign Substance in the Eye (Chemical Burn)
Getting unexpectedly splashed or sprayed in the eye by substances other than clean, harmless water can be scary. Some substances burn or sting but are fairly harmless in the long run, while others can cause serious injury. The basic makeup of the chemical involved can make a lot of difference, such as:
- Acid. As a general rule, acids can cause considerable redness and burning but can be washed out fairly easily.
- Alkali. Substances or chemicals that are basic (alkali) are much more serious but may not seem so because they don't cause as much immediate eye pain or redness as acids. Some examples of alkali substances are oven cleaners, toilet bowl cleaners and even chalk dust.
Chemical exposures and burns are usually caused by a splash of liquid getting in your eye. But they can be caused in other ways as well, such as by rubbing your eyes and transferring a chemical from your hands to your eyes or by getting sprayed in the eye by hair spray or other aerosols.
If you're splashed in the eye, put your head under a steady stream of barely warm tap water for about 15 minutes. Just let it run into your eye and down your face.
Then call your eye doctor or an emergency room/urgent care center to see what is recommended for your eye injury. Tell the person on the phone exactly what kind of substance got into your eye and what you've done about it so far.
If you know your eye is at risk because it's extraordinarily red or blurry, then just go immediately to your eye doctor or an emergency room or urgent care center after you've rinsed it with water. You can put a cool, moist compress or an ice pack on your eye, but don't rub it.
Depending on the substance, the effects of chemical exposures causing eye injuries can range from minor irritation and red eyes to serious eye damage and even blindness.
Black eyes are common eye injuries and often can be treated with an ice pack to reduce swelling.
Eye swelling and puffy, swollen eyelids can result from being struck in the eye such as from a baseball moving at a high speed. The best immediate treatment for this type of eye injury is an ice pack.
You may have a simple black eye (bruising around the eye), but you should see an eye doctor to make sure there's no internal damage.
Subconjunctival Hemorrhages (Eye Bleeding)
This eye injury usually looks worse than it really is. A subconjunctival hemorrhage involves leakage of blood from one or more breaks in a blood vessel that lies between the white of the eye (sclera) and its clear covering (conjunctiva).
Subconjunctival hemorrhages are quite common and can occur from even minor injury to the eye. They may be limited to a small sector of the eye, or they can extend over the entire eye, making the white sclera appear bright red.
A subconjunctival hemorrhage is painless and does not cause temporary or permanent vision loss. No treatment is required. Over the course of several weeks, the blood will clear and the eye will return to a normal appearance.
Traumatic iritis is inflammation of the colored part of the eye that surrounds the pupil (iris) and occurs after an eye injury. Traumatic iritis can be caused by a poke in the eye or a blow to the eye from a blunt object, such as a ball or a hand.
Traumatic iritis usually requires treatment. Even with medical treatment, there is a risk of permanent decreased vision.
Hyphemas and Orbital Blowout Fractures
A hyphema (high-FEE-mah) is bleeding in the anterior chamber of the eye, the space between the cornea and the iris. Orbital blowout fractures are cracks or breaks in the facial bones surrounding the eye.
Hyphemas and blowout fractures are serious eye injuries and medical emergencies. They are caused by significant blunt force trauma to the eye and face, such as getting hit by a bat, baseball, hockey stick or puck, or getting kicked in the face.
Steps to Take in Case of Eye Injury
If you have any eye injury, contact your eye care practitioner immediately for advice.
Most eye doctors have emergency contact numbers for injuries that occur after normal business hours or on weekends.
In certain extreme situations such as a penetrating eye injury or an eye knocked out of the socket, it may be better to get to the hospital immediately without taking the time to try calling anyone.
Once you are in the care of a doctor, be sure to mention if you wear contact lenses so you can be advised whether to leave them in or remove them.
Depending on the type of eye injury, the doctor may want you to flush your eye with water or saline solution. In more serious situations, you may need surgery.
Treat all eye injuries as potential emergencies, and never hesitate to contact or see an eye doctor immediately. Don't take risks with your eyesight. Remember, you have only one pair of eyes.
Gary Heiting, OD, also contributed to this article.
[Page updated February 2015]