Hesperian Health Guides
Eye Emergencies and Injuries
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Some eye problems like injuries are clearly emergencies. Other eye problems may seem less urgent, such as signs of illness or infection, but if there are danger signs, they too can quickly lead to blindness.
Protect the eye and send the person to get emergency medical help for these danger signs:
- Sudden loss of vision in one or both eyes
- Any injury that cuts into the eyeball or eyelid
- An injury with blood inside the colored part of the eye
- Severe pain in the eye with a white-grayish spot on the clear part (cornea). Treat with antibiotic ointment on the way to help. This could be an ulcer on the cornea
- Severe pain inside the eye. This could be iritis or acute glaucoma.
- Pus inside the colored part of the eye
- In a baby or child, a cloudy or white pupil
- Seeing small spots (floaters) are not an eye emergency unless they start suddenly along with flashes of light. This can happen when the retina, a part inside the eye, comes loose from the back of the eye. Surgery is needed soon to prevent loss of vision.
- Sudden double vision, especially in both eyes at once, can be a sign of several problems.
Also treat as an emergency any infection or inflammation that does not get better after 4 days of antibiotic ointment or drops.
Injuries to the eye
Anything sharp or that can scratch the eye, such as thorns, branches, or pieces of metal from factory or other work, can seriously injure the eye. Treatment by an experienced health worker is important so injury does not lead to blindness. Even small scratches or cuts can get infected and harm vision if not cared for correctly. A wound inside the eyeball is especially dangerous.
If the eye has been hit hard with a fist, stone or other hard object, the eye is in danger. And if the eye becomes very painful 1 or 2 days after being hit, this could be acute glaucoma.
- The person cannot see well with the injured eye.
- There is a thorn, splinter, or other object stuck in the eye.
- The wound is deep.
- There is blood or pus inside the colored part of the eye.
- The pupils do not get smaller in response to brighter light.
Apply an antibiotic eye drop if available and cover the eye by taping a paper cup over the eye, gently bandaging around the object, or using a cone made out of stiff paper. Send the person for medical help.
If the person has none of these danger signs and can see well with the injured eye, apply antibiotic eye treatment, lightly cover the eye with a clean eye pad, and wait for a day or two. But if the eye does not improve, get medical help.
Bleeding behind the cornea (hyphaema)
Blood in the colored part of the eye (the iris) is serious. The blood is trapped behind the clear covering (cornea) and may cover the iris. The person will not see well and may feel pain. The cause of this kind of bleeding is usually because the eye was hit with something hard, like a fist or stone. Send the person to an eye specialist right away. Have him sit upright on the way so that the bleeding does not block his vision.
If there is blood in the white part of the eye, usually it is not dangerous and will go away in a few weeks.
Pus behind the cornea (hypopyon)
Pus trapped between the clear covering (cornea) and the colored part of the eye (iris) is a sign that eye is in danger. The pus shows there is severe inflammation. This can occur because of an ulcer on the cornea or after eye surgery. Put antibiotic eye ointment in the eye and send the person for medical help right away
Injuries to the eye from chemicals
When cleaners, pesticides, gasoline (petrol) or other fuels, car battery acid, snake venom, lime powder (limestone), or other chemicals get into the eye, they can cause immediate injury so it is important to act quickly.
- You will need lots of clean water to pour on the eye.
- Have the person lie down.
- The chemical may be trapped under the eyelid. Hold the eye or eyes open (the injured person or another person can help) as you gently pour the water onto the eye to rinse it.
- As you wash the chemical out, don’t let the water run from one eye into the other. If only one eye is affected, tilt the head so the water runs toward the side of the head, not toward the other eye. If the chemical went into both eyes, tilt the head back and pour the water on the nose so that it runs toward both eyes at the same time.
- Keep pouring water gently over the eye or eyes for at least 15 minutes to 30 minutes. The chemical may still be causing harm to the eye even if it seems to have washed away.
- After rinsing, put antibiotic ointment in the affected eye or eyes and send the person for medical help.
|When police use chemicals such as pepper spray and tear gas that irritate or harm the eyes, first aid help includes moving away as quickly as possible and rinsing eyes with water.|
Protect eyes when injured or healing
After an injury, a paper cup or an eye cone can protect the eye while the person goes for emergency help. The eye cone will help remind the person not to rub her eye by mistake and can prevent the injury from getting worse.
Make an eye cone
|1. Cut a circle out of a clean piece of heavy paper or thin cardboard.|
|2. Cut into the middle in a straight line, and make a small hole in the middle.|
|3. Make a cone shape.|
|4. Tape the cone, outside and inside.|
|5. Tape the cone over the injured closed eye using tape that sticks well to skin.|
If you cannot make an eye cone or the injury is not severe, use an eye pad. If a person had an operation, help change the eye pad often. If there are signs of infection, like redness and discharge, this is a sign the eye needs urgent treatment. In this case, covering the eye can make it worse.
Make an eye pad
|1. Wash your hands well with soap and water.|
|2. Do not touch the eye with your hands.|
|3. Ask the person to shut both eyes while you cover the eye that needs the eye pad.|
|4. Cover the eye with sterile gauze or a very clean cloth cut into a square (6 centimeter sides).|
|5. Layer another 1 or 2 squares over the eye and use long strips of adhesive tape that sticks to skin to keep the eye pad in place.|