Eye injuries represent a concern for everyone. In fact, of all body parts damaged, it is injury to the eyes that causes the most anxiety. Eyesight is precious, and our lives revolve around our eyes. Correct first aid in case of an eye injury will minimize pain and may help prevent permanent vision loss.
Penetrating injuryThis type of injury produces more anxiety than any other eye injury because it carries great risk of permanent visual impairment. You can assume that any victim with a penetrating eye injury will probably have some permanent vision loss as a consequence. Such victims rarely end up with unscathed 20/20 vision, and any delay in acquiring medical care could result in loss of the eye altogether.
Most penetrating injuries of the eye are fairly obvious. Suspect penetration anytime you see a lid laceration or cut. Often, first-aiders concentrate upon the lid injury and neglect the penetrating eye injury. A penetrating injury requires immediate opthalmological attention. Only a physician should remove large foreign bodies impaled in the eye (preferably an opthalmologist).
Protect the eye with a paper cup or cardboard cone to prevent the object from being driven farther into the eye. Do not apply a patch over the damaged eye; however, cover the other eye with a patch in order to discontinue movement of the damaged eye due to sympathetic eye movement.
Far more common than penetrating eye injury, blunt trauma is less threatening to vision. A blow to the orbit or bones surrounding the eye can produce a fracture. These types of blows may come from a baseball bat, club, fist, etc.
Bleeding into the anterior (front) chamber of the eye produces hyphema. Racquetball is a common cause of this type of injury. Within an hour or two after injury, blood from the injured vessels in the eye is often visible as a red haze in the anterior chamber. Most opthalmologists consider a hyphema grounds for hospital admission. The treatment is bed rest.
Any victim complaining of pain, double vision or decreased vision after a blunt injury to the eye region should be transported to a medical facility.
Depending upon the chemical, these types of injuries vary in their severity. Acid injuries - from an exploding car battery, for example - are surprisingly well-tolerated. First aid consists of irrigating the eye with water.
This procedure should last for at least five minutes. Controversy exists about whether or not to patch the eye. Protect the undamaged eye from the acid.
Alkali or base chemicals cause more concern. Unlike acid, which is neutralized rapidly on the surface, alkalis (i.e., lye) penetrate deeply and continue to do damage. No matter how well the eye is irrigated, some alkali will always remain to cause tissue damage, often for weeks. Nevertheless, the eye must be immediately irrigated with water. This irrigation should continue for 20 minutes. A first-aider can't use enough water on these injuries. Again, controversy exists as to whether or not a chemically burned eye should be patched before seeking medical treatment.
Foreign bodies in the eye represent the most frequent eye injury. These objects come from flying particles and lodge under the eyelid or on the eyeball. They can be very painful and tearing is very common as the body's way of attempting to remove the object.
First, try to flush the object out by rinsing the eye gently with water. You may have to help hold the eye open. Tell the victim to move the eye as it is rinsed.
If rinsing does not work, the object is probably stuck under the upper or lower lid. Examine the lower lid by pulling it down gently. If you see the object, flush the eye with water. To examine the upper lid, grasp the lashes of the upper lid, place a match stick or Q-tip across the upper lid and roll the lid upward over the stick or Q-tip. If you see the object, remove it with a moistened, sterile gauze.
If the object is on the sclera (white part of the eye), have the victim look down while rinsing the eye with water. If the object is on the surface of the cornea, rinse the eye with water. Do not touch the cornea with gauze. Remember, do not remove an impaled object from an eye.
These injuries can result from looking at ultraviolet light (such as "arc welder" or sunlight). Severe pain occurs a few hours after exposure. Patch both eyes with cold, moist compresses and prevent light from reaching the victim's eyes. Call an opthalmologist for advice.
Eye injuries have great significance because of the risk of blindness. Always seek medical advice for such victims.
-Alton Thygerson is a professor of health sciences at Brigham Young University.