After reading this article, be sure to visit our trauma section
for pictures of eye
Eye injuries range from minor foreign bodies, scratches,
conjunctivitis and major trauma.
When an eye is injured, there is often associated pain and
panic. Individuals have a high degree of anxiety and rightfully
so. The fear of loss of vision is very frightening.
When one injures an eye in the outdoors, the panic may lead
to a thrashing about, running around and therefore higher
risk for further injury.
One must become a psychologist at this time, decrease anxiety
and follow a few basic steps. When going into the outdoors
for any length of time, one should always carry an extra pair
of corrective lenses, whether they are glasses or contacts.
Safety straps are crucial, especially when climbing, canoeing
or involved in water sports. Sunglasses are also important
to decrease the effects of the sun, as well as snow blindness
in the winter.
Foreign bodies of the eye
One of the most common and painful occurrence in the outdoors
is a foreign body to the eye. The tiniest of foreign bodies
can feel like a large rock, causing great discomfort. Individuals
need to remain calm and allow someone to assess the eye.
Assessment of the eye with foreign body
- Spread upper and lower lids apart.
- Shine light from the side of an eye.
- The foreign body should be visible on the surface of
- Attempt irrigation of the eye with water. To create a
good stream for irrigation, pour water in a plastic bag,
put a pinhole in one end and squeeze the bag. You now have
a pressurized irrigation system. If the foreign body does
not dislodge, you can use a small piece of cloth or cotton
ball, wet the tip and use it to remove the foreign body.
You can also use a cotton-tipped applicator to gently brush
the foreign body away.
- Always check under the upper lid, even if you have already
removed a foreign body. If this is missed, scratches may
continue to occur when the patient continues to blink (see
photo of lid eversion and foreign body). If nothing is visualized
under the upper lid, take a piece of cotton or cloth and
gently sweep the everted upper lid. This will help ensure
that all tiny particles are removed.
- It is very common for individuals to feel a foreign body
sensation after a foreign body has been removed. This is
most likely due to a tiny scratch on the cornea.
- Antibiotic eye drops are helpful as a preventative for
infection if they are available in your medical kit.
To patch or not to patch, that is the question. After a foreign
body is removed from the eye, it is usually better if the
eye is not patched. All wounds need oxygen to heal, including
eye injuries. A patch should only be given for the patient’s
comfort. In fact, recent research studies have shown corneal
abrasions heal slower when patched as opposed to not being
Ruptured, lacerated globe of eye
One can be hammering metal tent stakes and get shards of
metal into their eye, a limb may hit the eye, or one may fall,
striking their face. All could potentially rupture an eyeball.
Ruptured eyeballs are not always very obvious. If you should
suspect a ruptured globe of the eye, immediate transportation
to a health care provider is imperative. Avoid high altitudes.
It is better if the individual is not airlifted out. However
that may be the quickest method of transport. These eye injuries
should be covered with a bulky dressing. No pressure should
be applied to the eye. A plastic cup placed over the eye is
helpful to prevent any pressure, as well as preventing the
patient from touching or putting pressure on the eye. Observe
for drainage, blood behind the eye, or a clear liquid drainage.
Do not give steroids as they increase intraocular pressure.
Benign ruptures of blood vessels are commonly seen on the
whites (sclerae) of the eyes. Causes vary, from coughing,
sneezing or blood pressure increase. If trauma is suspected,
evaluate very closely for a globe rupture. However subconjunctival
hemorrhages are very benign. They look terrible, but always
resolve in 2-4 days.
Snow blindness is mild sunburn of the cornea of the eye.
Symptoms do not usually occur for 6-10 hours. A burning sensation
with some blurred vision is possible. Depending on the severity
and degree of pain, transport needs to be assessed. Sunglasses
are important to make the patient more comfortable. These
individuals are usually very photophobic (sensitivity to light).
These injuries are very similar to welder’s burns.