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Eye emergencies

• Overview
• Symptoms
• Treatment
• Prevention

First Aid:

Take prompt action and follow the steps below if you or someone else has an eye-related injury.

SMALL OBJECT ON THE EYE OR EYELID

The eye will often clear itself of tiny objects, like eyelashes and sand, through blinking and tearing. If not, take these steps:

1. Tell the person not to rub the eye. Wash your hands before examining it.
2. Examine the eye in a well-lighted area. To find the object, have the person look up and down, then side to side.
3. If you can't find the object, grasp the lower eyelid and gently pull down on it to look under the lower eyelid. To look under the upper lid, you can place a cotton-tipped swab on the outside of the upper lid and gently flip the lid over the cotton swab.
4. If the object is on an eyelid, try to gently flush it out with water. If that does not work, try touching a second cotton-tipped swab to the object to remove it.
5. If the object is on the eye, try gently rinsing the eye with water. It may help to use an eye dropper positioned above the outer corner of the eye. DO NOT touch the eye itself with the cotton swab.

A scratchy feeling or other minor discomfort may continue after removing eyelashes and other tiny objects. This will go away within a day or two. If the person continues to have discomfort or blurred vision, get medical help.

OBJECT STUCK OR EMBEDDED IN EYE

1. Leave the object in place. DO NOT try to remove the object. DO NOT touch it or apply any pressure to it.
2. Calm and reassure the person.
3. Wash your hands.
4. Bandage both eyes. If the object is large, place a paper cup or cone over the injured eye and tape it in place. Cover the uninjured eye with gauze or a clean cloth. If the object is small, cover both eyes with a clean cloth or sterile dressing. Even if only one eye is affected, covering both eyes will help prevent eye movement.
5. Get medical help immediately.

CHEMICALS IN THE EYE

1. Flush with cool tap water immediately. Turn the person's head so the injured eye is down and to the side. Holding the eyelid open, allow running water from the faucet to flush the eye for 15 minutes.
2. If both eyes are affected, or if the chemicals are also on other parts of the body, have the victim take a shower.
3. If the person is wearing contact lenses and the lenses did not flush out from the running water, have the person try to remove the contacts AFTER the flushing procedure.
4. Continue to flush the eye with clean water or saline while seeking urgent medical attention.
5. After following the above instructions, seek medical help immediately.

EYE CUTS, SCRATCHES, OR BLOWS

1. If the eyeball has been injured, get medical help immediately.
2. Gently apply cold compresses to reduce swelling and help stop any bleeding. DO NOT apply pressure to control bleeding.
3. If blood is pooling in the eye, cover both of the person's eyes with a clean cloth or sterile dressing, and get medical help.

EYELID CUTS

1. Carefully wash the eye. Apply a thick layer of bacitracin or mupirocin ointment on the eyelid. Place a patch over the eye. Seek medical help immediately.
2. If the cut is bleeding, apply gentle pressure with a clean, dry cloth until the bleeding subsides.
3. Rinse with water, cover with a clean dressing, and place a cold compress on the dressing to reduce pain and swelling.

Do Not:

• DO NOT press or rub an injured eye.
• DO NOT remove contact lenses unless rapid swelling is occurring, there is a chemical injury and the contacts did not come out with the water flush, or you cannot get prompt medical help.
• DO NOT attempt to remove a foreign body that appears to be embedded in any part of the eye. Get medical help immediately.
• DO NOT use cotton swabs, tweezers, or anything else on the eye itself. Cotton swabs should only be used on the eyelid.
• DO NOT attempt to remove an embedded object.

Call immediately for emergency medical assistance if:

Seek emergency medical care if:

• There appears to be any visible scratch, cut, or penetration of your eyeball.
• Any chemical gets into your eye.
• The eye is painful and red.
• Nausea accompanies the eye pain.
• You have any trouble seeing (such as blurry vision).

References:

Yanoff, M, Duker, JS and Augsburger, JJ, et al. Ophthalmology . 2nd ed. St. Louis, Mo: Elsevier; 2004:1391-1396.

Auerbach PS. Wilderness Medicine . 4th ed. St. Louis, Mo: Mosby; 2001.

• Review Date: 2/22/2007
• Reviewed By: Manju Subramanian, MD, Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network.

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