Ocular Trauma

EYE INJURIES

Injuries to the eye and surrounding structures can be caused by blunt trauma from a ball or fist, sharp trauma such as a stick or projectile, or chemical trauma such as splash from a caustic substance like a cleaning material or pool supplies

Which part of the eye can be injured?

Injuries to the eye can involve the eyelids, the bones surrounding the eye, and the eyeball itself.

What are some common injuries to the eyeball itself?

The front, clear surface of the eye called the cornea can be scratched and often causes pain, redness and tearing. The physician usually makes the diagnosis by placing a yellow dye (fluorescein) into the eye, which highlights the scratch. Treatment involves using antibiotic eye drops/ointment and occasionally a pressure patch on the eye. These injuries require close follow up with the ophthalmologist.

What if the scratch goes deeper than the surface?

Sharp objects (such as a stick, shard of glass, or metallic item) can actually cut the surface of the eye causing a laceration. This type of injury places a child at risk for permanent loss of vision. Lacerations require prompt attention (usually surgical intervention) by an ophthalmologist to prevent complications and maximize vision potential.

Can being struck with a ball or elbow during play cause damage inside the eye?

Yes. Blunt trauma can cause bleeding inside the eye hyphema. The blood in the eye can cause increased pressure, which can result in permanent vision loss. Trauma associated with swelling of the eyelid, red eye, pain, or discharge should be evaluated by an ophthalmologist promptly.

What should happen if a chemical or cleaning solution splashes into a child's eye?

The first thing to do when any abnormal liquid gets into the eye is to immediately flush the eye with water. Rinsing the chemical out of the eye decreases the chance of long-term problems. The next step is to promptly contact your doctor or go to the emergency department for evaluation. It is important to take the chemical or solution to the evaluation to help the doctor determine appropriate treatment.

What are the most common causes of eye injuries in children?

Pediatric eye trauma most often occurs at school or during play. Approved and tested eye and face protection is essential to prevent injuries. Sports such as hockey, baseball, racquet ball, squash, and even baseball require protective goggles or full face mask wear at all times.

What should happen when a child gets an eye injury?

A child that sustains an eye injury should seek immediate medical attention from an ophthalmologist to assess the vision function and carefully examine all the structures of the eye. Frequent examinations until the eye is completely healed are often necessary.

PREVENTING INJURIES
  • * Children should wear sports eye protectors made with polycarbonate lenses
  • * All chemicals and sprays must be kept out of reach of small children.
  • * Parents and others who provide care and supervision for children need to practice safe use of common items that can cause serious eye injury, such as paper clips, pencils, scissors, bungee cords, wire coat hangers and rubber bands.
  • * Only purchase age-appropriate toys.
  • * Avoid projectile toys such as darts, bows and arrows, and missile-firing toys.
  • * Use safety gates at the top and bottom of stairs. Pad or cushion sharp corners. Put locks on all cabinets and drawers that kids can reach.
  • * Do not allow children anywhere near fireworks, especially bottle rockets. These fireworks pose a serious risk of eye injury and have been banned in several states.
  • * On the road, make sure children are properly secured in baby carriers and child safety seats and that the seat and shoulder belts fit well. Children age 12 and younger should never ride in the front seat. Store loose items in the trunk or secured on the floor, as any loose object can become a dangerous projectile in a crash.

FIRST AID

An ophthalmologist, optometrist , school nurse or children's health service should examine the eye as soon as possible, even if the injury seems minor at first, as a serious injury is not always immediately obvious. Delaying medical attention can cause the damaged areas to worsen and could result in permanent vision loss or blindness.

While seeking medical help, care for the child as follows:
  • * DO NOT touch, rub or apply pressure to the eye.
  • * DO NOT try to remove any object stuck in the eye. For small debris, lift eye lid and ask child to blink rapidly to see if tears will flush out the particle. If not, close the eye and seek treatment.
  • * Do not apply ointment or medication to the eye.
  • * A cut or puncture wound should be gently covered.
  • * Only in the event of chemical exposure, flush with plenty of water.