Eye Injuries: How to Treat and When to See a Doctor

Here is a list of the common traumatic eye injuries that may occur in the workplace, at home or whilst playing sports.

1. Black eye

Bruising around your eye can occur when there has been trauma or forceful impact to your face. Your eye may be sensitive to touch and painful when you try to open, close, or move it, and there may be swelling of the eye and its surrounding area.

Home remedy

• Apply a cold compress soon after the injury: Gently place a clean cold pack or a cloth filled with ice to the area around your eye as soon as possible after the injury to reduce swelling. Take care not to press hard on the eye itself. Repeat several times a day for a day or two.
  
  
• Apply warm or hot compresses: This may be helpful to reduce bruising a few days after the injury. Repeat several times a day for a day or two.
  

When to see a doctor

Seek medical help if you:

• Suspect a foreign body has gotten stuck in your eye during the impact.
• Have any significant cut or injury to your eyelids.
• Have vision problems, such as 
  • Double vision, 
  • blurred vision or 
  • Other visual disturbances such as a sudden increase in floaters or flashes.
• Have severe pain, or blood flowing from your eye area or nose.

2. Orbital fracture

An orbital fracture happens when the bones surrounding the eyeball are broken, such as during car accidents, sports injuries, fights or falls. Such traumatic events can also cause damage to the eyeball, eyelids, or the muscles and nerves around the eye.

Home remedy and treatment

Bruising and swelling around the eye tends to occur when an orbital fracture is present. Hence, clean cold packs in the initial stages may be helpful, followed by gentle warm compresses subsequently.

Avoid blowing your nose after any forceful impact to the eye area. Surgery may be necessary for more severe cases where the eye is unable to move properly.

When to see a doctor

You should seek immediate medical attention if you experience any severe blunt force trauma to your eye, particularly if you have vision problems thereafter, double vision presenting only with both eyes open or numbness of your cheek area.

3. Hyphema (blood accumulation at the central part of the eye)

A hyphaema is the accumulation of blood inside the anterior chamber, the space between the iris and cornea at the central part of the eye which where you normally see your iris and pupil.

This can result in sensitivity to light and block your vision partially or completely and if left untreated, may lead to high eye pressure and other permanent vision problems.

This is in contrast to a subconjunctival haemorrhage, which is blood at the white part of the eye. In isolation, this is usually benign, will not result in any visual problems and will resolve by itself without treatment in time.

Home remedy

Mild hyphemas may resolve on their own in about a week with sufficient rest but it may not be noticeable to the naked eye. Any noticeable hyphaema should be reviewed by a doctor.

Minimise physical activity after any hyphaema is diagnosed for 5-7 days after the injury and sleep with the head propped up to 45 degrees or more to prevent rebleeding and expedite resolution of any blurred vision.

When to see a doctor

If a hyphaema can be seen, review by an ophthalmologist is required. This is particularly urgent if you have very blurry vision, eye pain, nausea or vomiting.

4. Corneal abrasion (scratch on the cornea)

Foreign bodies such as dirt trapped under the eyelid, fingernails and even contact lenses may result in scratches on your cornea, the clear, dome-shaped surface that covers the front of the eye.

Symptoms of corneal abrasions include:

• Eye redness,
• Pain,
• Blurred vision,
• Tearing and
• Sensitivity to light.

Furthermore, these wounds may potentially get infected, resulting in worsened symptoms, more complicated treatment and potentially worse visual outcome.

Remedy and whe to see a doctor

You should consult an eye doctor for treatment immediately if you know something has scratched your eye.

Some immediate steps which you can take after experiencing a corneal abrasion include:

• Rinsing your eye with sterile saline solution or
• Using copious preservative-free eye drops to wash out the foreign object.

What to avoid

Do not attempt to remove any object which is embedded in your eye!

Avoid rubbing your eye, wearing contact lenses, swimming, contact with anything dirty such as soil, or even washing your eye with tap water as this may result in infections.

5. Chemical burns

A chemical burn typically occurs when any liquid or powdered chemical compound gets into your eye, such as in cases of splash injuries or if you rub your eye without washing your hands after handling these chemicals.

The eye will be very red and painful, with tearing and blurred vision.

Remedies and when to see a doctor

Irrigate the eye immediately with copious clean water after any chemical has entered the eye and seek medical attention urgently.

Take note of the type of chemical that entered the eye – take a photo of the label or bring the packaging along with you to the emergency department. 

The damage sustained is dependent on the type of chemical, the amount that entered the eye and the duration the chemical has been in contact with the eye.

6. Foreign objects

Wind may sometimes blow dust into the eye, or eyelashes may sometimes fall into the eye, both causing eye irritation but seldom, pain.

Contact lenses may also be difficult to remove from the eye at times, particularly after a long day of wear when the eye is very dry.

Other foreign objects such as metal particles or glass shards may accidentally get into the eye and lead to potentially serious eye injuries.

Remedy and when to see a doctor

Try instilling copious preservative-free eye drops as frequently as needed if any dust has blown into your eye. If symptoms persist despite this, or if you experience pain or blurred vision, review by an eye doctor is warranted.

If an eyelash falls into the eye, you may try using a clean cotton bud moistened with cool, boiled, clean water or lubricating eye drops to remove it gently from the white part of the eye.

After prolonged contact lens wear, try and instill some preservative-free lubricating eye drops into the eye to facilitate removal of the contact lens. If you have difficulty removing it, see an eye doctor for assistance.

Removal of anything else from the eye should not be attempted by yourself, particularly if the foreign object is seen sticking out of the eye, or is located over the cornea. Consult an eye doctor immediately in such circumstances.

The symptoms of an eye injury will vary, depending on the mechanism of injury and type and severity of injury sustained, and may include the following symptoms:

1. Pain, swelling and bruising

If you experience severe or prolonged eye pain, or extensive swelling or bruising, please seek medical attention.

2. Changes in your vision

A sudden increase in floaters (they may appear like translucent spots, circles, hair or spiderwebs in your vision) or frequent flashes in your vision could signify a retinal tear so an urgent eye review should be sought.

Double vision presents only when both eyes are open after any history of blunt force to the eye area may suggest the presence of an orbital fracture.

Significant blurring or loss of vision is another red flag that specialist attention is required.

3. Changes in the appearance of your eye

Changes to the size and shape of your pupil – if your pupil appears misshaped (not circular), or if there is a significant difference in the size of both pupils, please seek medical evaluation.

White patches on the usually transparent cornea at the front of the eye may be due to infection, particularly if accompanied by pain and a preceding history of trauma or contact lens use.

Significant trauma may also cause damage to your eyelid, in the form of cuts or tears or droopiness.

4. Bleeding or redness in the eye

Blood flowing out of the eye or a hyphaema (as described earlier) must be seen by an eye doctor immediately.             

The eye is our visual gateway to the world. Thus, it is important to protect them from injury. Here are precautions you can take to protect your eyes.
 

Ref: F26
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