Eye Injuries and Foreign Bodies: First Aid for Adults

Introduction

When someone injures an eye or gets a foreign object in it, it may be normal for others nearby to either panic or to use cold water to try to alleviate the problem. Neither of these responses is especially useful, however, so here are a few quick tips in case this ever happens to you.

Trauma

When someone has been hit in the eye, protect it with a temporary shield made from a foam drinking cup taped to the bone around the eye. Do not touch or put pressure on the lids or the eye itself.

Get to the person to the nearest hospital emergency department as soon as possible, by calling for an ambulance. Do not allow the injured person to drive, and avoid driving yourself if at all possible. For the bruising around the eye that may follow an injury which most people call a “black eye,” use gentle ice packs or cold cloth over the eye, but be careful not to apply pressure. Anyone who suffers a blow to the eye area severe enough to cause bruising should be seen by an eyecare practitioner or by a physician in the emergency department of a hospital for an X-ray to rule out bone breakage.

(Image left : Most people don’t realize how serious a “black eye” can be.)

While the bones of the outer skull are thick and relatively sturdy, the bones surrounding the eye and the muscles controlling eye movement are thin and fragile; it is possible for them to break from a blow to the eye that forced the eye back into the skull. Such a breakage, called a 'blowout fracture', definitely requires treatment, because the muscle tissues may become caught in the bone fragments and could cause double vision if the fracture heals incorrectly.

Foreign Body

If something has gotten into the eye, do not touch it with fingers or tweezers, as this may cause further injury or force the object in deeper. If a source of clean water is available, flush the eye without otherwise touching it. The foreign body may dislodge and float out again without further damage, although the person should see an eyecare practitioner as soon as possible to make sure there is nothing left there and to be sure there is no infection or abrasion requiring care.

Chemical Burn

If someone has sustained a fluid splashing into the eye(s), read the label to determine the first treatment. This is important because the effects of some types of chemicals are worsened by adding water, while others should be washed out as soon as possible.

If the labeling indicates flushing the eyes with water, do so for at least 15 minutes, by holding the person’s eyes under the tape or using a clean container to catch the runoff as you pour it into the eye. While rinsing, hold the eyes open if possible, so that the water reaches well up under the lids and gets the greatest possible coverage.

Call for an ambulance or have someone else do so while you are rinsing. If the label is not available, get to the emergency department of the nearest hospital as soon as possible.

Seek Immediate Medical Attention

If you ever find yourself in any of the following situations, seek help as soon as possible by calling for an ambulance or going to the nearest emergency department for help:

• If someone has obvious eye pain or vision problems

• If there is a cut or torn eyelid

• If one eye does not move as much as the other

• If the pupils of the eyes are different sizes, or if one does not change size like the other when the light is turned off or on, or if either pupil is abnormally shaped

• If there is any blood visible anywhere in or around the eye, in or on the white of the eye

• If there is something embedded in the eye

• If there is something under the eyelid that cannot be easily removed by rinsing.

Summary

As with any accidental injury, an ounce of prevention...

Be sure you use proper eye protection when working around fast-moving particulates, as at a workbench, for example, or mowing the lawn. Be sure your children’s eyes are protected also, and anyone else’s who enters the area.

As part of a first-aid kit, stock at least two containers of sterile saline solution, which can be found in stores that stock contact lens solutions. Choose solutions that are labeled for rinsing the lenses before inserting them, because these are meant for use in the eye and will do no harm other than perhaps a minor allergic reaction to a preservative. Replace these periodically, because the preservatives in them lose effectiveness over time, as indicated by the expiration date on the bottle. Most of these come in squirt-bottles so you can aim the fluid up under the lids.

(Image right: Contact lens solutions used for rinsing lenses are a great addition to your first aid kit, useful for flushing fluids out of the eyes and for rinsing abrasions elsewhere on the body.)

Sometimes the best thing you can do is just to stay calm and call for help. This may be easier said than done, but you can always panic later.