Emergency Eye Injury Treatment
Hyphema in the Eye
About the Author
Melissa Flagg is an ophthalmic technician and has been examining patients on a daily basis for over 20 years.
She has had rigorous training under the supervision of an ophthalmologist and specialized in the cornea, cataracts, and retina as well as how systemic disease affects the eye. She has been certified by JCAHPO as a Certified Ophthalmic Assistant.
Preventing an eye injury is the best way to prevent damage to the vision; however, some injuries are inevitable.
Knowing what to do when an eye injury occurs can go a long way to preventing permanent vision loss, or total blindness. But it’s imperative that you don’t panic.
There are a number of different types of ocular (eye) injuries that can occur. Some are as simple as a slight scratch on the cornea; others are as invasive as a pencil that penetrates the eyeball, also called the globe.
The type of injury determines what emergency measures are to be taken.
Types of Injury to the Eye
Some eye problems need to be seen within hours of the initial symptoms. For example, a central retinal artery occlusion must be seen by an ophthalmologist within 60 minutes of onset to avoid total and permanent blindness. Other ocular problems that must be seen within hours of onset include:
A Corneal Abrasion
- Chemical burns
- Penetrating ocular injuries
- Sudden onset of partial or total blindness
- Sudden onset of blurred vision
Some eye injuries are emergencies, but do not need to be seen immediately. Urgent eye injuries that should be seen within 24 hours of onset include:
An Orbital "Blowout" Fracture
There are other ocular problems that should be seen within days of onset, and these problems include:
- Optic neuritis (swelling of the optic nerve)
- Ocular tumors
- Protrusion of an eye
- Previously undiagnosed glaucoma
- Undiagnosed or old retinal detachment
Central Retinal Artery Occlusion
Because CRAO or central retinal artery occlusion can cause permanent blindness so quickly, it deserves a bit of explanation.
CRAO is caused by a blood clot in the main artery that supplies blood to the retina. The retina is essentially an extension of the brain because of its complex structure. Because of this, deprivation of oxygen causes permanent damage to the vision within minutes.
Treatment for CRAO usually involves medications that are meant to dilate the blood vessels in the eye so that the clot can pass through the artery and out of the eye. Medications typically used for CRAO include:
- Priscoline (tolazoline hydrochloride)
- Diamox (acetazolamide)
- Xylocaine (lidocaine hydrochloride)
- Vaporole (amyl nitrate)
- Carbachol inhalant gas
Treatment needs to be administered within 15 minutes of symptoms if the vision is to be saved. In some cases, some vision has been restored when treatment was initiated within 90 minutes of the onset of symptoms; however, the prognosis for vision is very poor the longer the treatment is delayed.
Acute Narrow Angle Glaucoma
Eye Injury Symptoms
If you have any of the following symptoms, you should see your ophthalmologist within 24 hours of the onset of the symptoms.
- Sudden loss of vision without pain (could indicate a central retinal artery occlusion)
- Sudden veil or curtain coming over your vision (could indicate a retinal detachment)
- Rainbows around lights (could be indicative of narrow angle glaucoma)
- Blurry vision with pain (may indicate iritis)
- Sensitivity to light associated with a foreign body sensation (may indicate a corneal abrasion or ulcer)
- Extreme pain, nausea or vomiting associated with rainbows around lights and/or loss of vision (may be indicative of narrow angle glaucoma)
- Double vision (may indicate a brain tumor, aneurysm, myasthenia gravis, or stroke)
- Drooping lid (may be indicative of stroke, aneurysm, or brain tumor)
Eye Injuries Treatment
If you have gotten something in your eye, such as a chemical, sand or other foreign body you need to flush your eye IMMEDIATELY with cold water.
If it’s a chemical that caused the injury, you need to flush the affected eye for a MINIMUM of 15 minutes.
If the chemical is an alkali, the eye needs to be flushed for 20 to 30 minutes.
Alkali chemicals are the most hazardous to the eye, even more so than acids. This is because the molecules of the chemical adhere to corneal and conjunctival tissue, and therefore will penetrate deeper than an acid.
Ideally, the eye should be irrigated until a doctor can see the patient; however, it is sufficient to irrigate the eye until arrangements can be made for the patient to see a doctor.
Penetrating or perforating injuries to the eye, while infrequent, do occur. A penetrating injury is caused by an object piercing the globe. It is usually something such as stone or wood or something sharp like a knife.
Corneal Foreign Body
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It is imperative that pressure not be put on the eyelids or the eyeball itself as this may cause extrusion of the contents of the eye. In other words, pressure may push the anatomical parts (such as the iris, retina, or vitreous) out of the eye through the wound.
If the object is still in the eye, DO NOT REMOVE IT! To do so can cause the ocular contents to collapse or be extruded through the wound. Movement of the eye should also be limited.
Perforating injuries are caused by an object entering the eye in one area and exiting the eye through another. As with penetrating trauma to the eye, movement should be limited. Pressure to the eye should also be limited to help prevent further damage to the contents of the eye. However, the patient should keep the eye closed to prevent anything else from entering into it.
I highly recommend avoiding a trip to the emergency room if at all possible. While ER doctors are excellent at dealing with trauma, when it comes to traumatic eye injuries, they can do more harm than good. They just don’t have the expertise of an ophthalmologist and may unknowingly give a patient the wrong treatment.
If you have suffered an eye injury, contact your ophthalmologist right away, walk into his or her office if you have to, but avoid going to the ER if at all possible.
Unfortunately, for things like retinal detachment, CRAO, or even blunt trauma to the eye (such as with a tennis ball) there really isn’t much the patient can do except get to the ophthalmologist right away.
In the case of retinal detachment, limiting the movement of the eye may help prevent further detachment. The best treatment is prevention. When working with chemicals, or playing a sport where an eye injury is likely to occur, always wear protective eyewear.
© Copyright 2012 - 2015 by Melissa "Daughter of Maat" Flagg ALL RIGHTS RESERVED