Eye Injury

EYE INJURY

DEFINITION

  • Injury to the eye, eyelid, or area around the eye.

General Information

  • Vision and Eye Injuries: It is important to test vision in both eyes. If there has been no damage to the vision, then most likely there is no serious injury to the eyeball. Test vision at home by covering each eye in turn and looking at a near object and then a distant object. Is the vision blurred in comparison to normal?
  • Black Eye: Bruising and purple discoloration of the eyelids and upper cheek is referred to as a "black eye." Usually it is the result of a direct blow to this area (e.g. a punch). It gets worse for the first couple of days. It usually goes away in 2-3 weeks.
  • Subconjunctival Hemorrhage: This is the medical term for a flame-shaped bruise of the white area of the eyeball, which sometimes occurs after a direct blow to the eye. It usually goes away in 2-3 weeks.

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WHEN TO CALL YOUR DOCTOR

Call 911 (you may need an ambulance) if:

  • Knocked out (unconscious)

Call your doctor now (night or day) if:

  • You think you have a serious injury
  • Vision is blurred or lost in either eye
  • Severe pain
  • Constant tearing or blinking
  • Double vision or unable to look upward
  • Bloody or cloudy fluid behind the cornea (clear part)
  • Object hit the eye at high speed (such as from a lawn mower)
  • Sharp object hit the eye (e.g. a metallic chip or flying glass)
  • Skin is split open or gaping and may need stitches
  • Any cut on the eyelid or eyeball
  • "Black eyes" bilaterally (on both sides)

Call your doctor within 24 hours (between 9am and 4pm) if:

  • You think you need to be seen
  • Large swelling or bruise (wider than 2 inches) at the site of the injury
  • Eyelids swollen shut
  • No tetanus booster in more than 10 years (5 years for dirty cuts and scrapes)

Call your doctor during weekday office hours if:

  • You have other questions or concerns
  • Pain has not improved after 3 days

Self care at home if:

  • Minor eye injury and you don't think you need to be seen
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HOME CARE ADVICE

  • Treatment of Superficial Cuts and Scrapes (abrasions) to Eyelid or Area around Eye:
    • Apply direct pressure with a sterile gauze or clean cloth for 10 minutes to stop any bleeding.
    • Wash the wound with soap and water for 5 minutes. (Protect the eye with a clean cloth).
    • Apply an antibiotic ointment.  Cover large scrapes with a Band-Aid or dressing. Change daily.
  • Treatment of Swelling or Bruise with Intact Skin:
    • Apply an ice pack to the area for 20 minutes each hour for 4 consecutive hours.
    • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.
  • Treatment of Subconjunctival Hemorrhage (flame-shaped bruise of the white area of eyeball): No specific treatment is required. It usually goes away in 2-3 weeks.
  • Pain Medication: For pain relief, take acetaminophen every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg).
    • Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
    • Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  • Call Your Doctor If:
    • Pain becomes severe
    • Pain does not improve after 3 days
    • Changes in vision
    • You become worse

And remember, contact your doctor if you become worse or develop any of the "Call Your Doctor" symptoms.

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REFERENCES

  1. American Heart Association. 2005 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 10: First Aid. Circulation. 2005;112:IV-196-IV-203.
  2. Baker SM, Hurwitz JJ. Management of ocular and adnexal trauma. Ophthalmol Clin North Am. 1999;12(3);435-455.
  3. Crumpton KL, Shockley LW. Ocular Trauma: a quick illustrated guide to treatment, triage, and medicolegal implications. Emerg Med Reports. 1997;18(23).
  4. Kaiser PK. A comparison of pressure patching versus no patching for corneal abrasions due to trauma or foreign body removal. Ophtalmology. 1997;104:169-70.
  5. Markoff DD, Chacko D. Common ophthalmologic emergencies: examination, differential diagnosis, and targeted management. Emerg Med Reports. 1999;20(1).
  6. Naradzay J, Barish RA. Approach to ophthalmologic emergencies. Med Clin North Am. 2006; 90(2): 305-28, vii-viii.
  7. Rubin S, Hallagan L. Lids, lacrimals, and lashes. Emerg Med Clin North Amer. 1995;13(3):631-7.
  8. Wilson SA, Last A. Management of corneal abrasions. Am Fam Physician. 2004;70(1):123-130.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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