Eye - Injury
First Aid - Eyelids - Glass On
- Injury to the eye, eyelid, or area around the eye
- The main concern in all eye injuries is whether the vision is damaged.
- A person with any change or loss of eyesight should see a doctor right away.
- It is important to test vision in both eyes. If there has been no loss of vision, then most likely there is no serious injury to the eyeball. Test vision at home by covering each eye in turn and looking at a near object and then a distant object. Is the vision blurred in comparison to normal?
Types of Eye Injuries
- Abrasion: This is the medical term for scraped skin. This happens when an injury scrapes off the top layer of the skin. Pain is usually mild. This can usually be treated at home.
- Contusion: This is the medical term for bruise. Bruising of the eyelids and upper cheek is also called a "black-eye". It most often results from a direct blow to this area, like a punch. The bruised skin may first look red, then purple, and finally orange-yellow. These skin color changes are from blood that leaked from tiny torn blood vessels in the bruised area. The skin may also be swollen. Pain is usually mild to moderate. Most often this can be treated at home. A black-eye gets worse for the first couple days. It usually goes away in 2-3 weeks.
- Corneal Abrasion (Corneal Scratch): A corneal abrasion is one of the most common eye injuries. The typical mechanism is an accidental scratch from a fingernail, piece of paper, or the branch of a tree. It can be very painful. It may feel like something is stuck in the eyeball. Generally, a minor corneal abrasion will heal in 1-2 days. It is treated with antibiotic eye drops and (sometimes) patching.
- Cut - Superficial: Superficial cuts (scratches) only extend partially through the skin and rarely become infected. A scratch is an injury to the skin made by a sharp edge. For example, scratches can be caused by fingernails, a sharp nail, a piece of metal, or a branch of a tree or bush. A paper cut is a scratch from the edge of a piece of paper. This can usually be treated at home.
- Cut - Deep: Deep cuts (lacerations) go through the skin. Lacerations longer than 1/4 inch (6 mm) on the face usually need sutures. A laceration is caused by cutting the skin with the sharp edge of an object.
- Orbital Fracture (Blow-out Fracture): This is the medical term for a broken bone of the eye socket. The bony walls of the socket in which the eye sits are thin and can be broken with blunt trauma. The appearance is similar to a "black eye." The pain and swelling are usually worse, and sometimes the patient may complain of double vision. A person with a more severe fracture may need surgery.
- Subconjunctival Hemorrhage: This is the medical term for a flame-shaped bruise of the white area of the eyeball. It sometimes happens after a direct blow to the eye. It looks as though a red patch was "painted" on to the eye. It usually goes away in 2-3 weeks.
- None: No pain. Pain score is 0 on a scale of 0 to 10.
- Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
- Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
- Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.
When to call your doctor
Call 911 Now (you may need an ambulance) If
- Knocked out (unconscious) for more than one minute
- You think you have a life-threatening emergency
Call Your Doctor Now (night or day) If
- You think you have a serious injury
- Eyesight is blurred or lost in either eye
- Severe pain
- Nonstop tearing or blinking
- Seeing double or cannot look upward
- Bloody or cloudy fluid behind the cornea (clear middle part of the eye)
- Object hit the eye at high speed (such as from a lawn mower)
- Sharp object hit the eye (such as a metallic chip or flying glass)
- Skin is split open or gaping and may need stitches
- Any cut on the eyelid or eyeball
- Black and blue skin around both eyes
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think you need to be seen
- Large swelling or a bruise at the site of the injury (2 inches or wider, 5 cm or wider)
- Eyelids swollen shut
- Last tetanus shot was more than 10 years ago (5 years for dirty cuts and scrapes)
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Eye pain is not better after 3 days
Self Care at Home If
- Minor eye injury
CARE ADVICE FOR MINOR INJURIES OF THE EYE
- What You Should Know:
- The face is structured to protect eyes from injury. An eye injury is serious if it causes changes in or loss of eyesight.
- You can treat minor eye injuries at home.
- Here is some care advice that should help.
- Treatment of Surface Cuts and Scrapes to Eyelid or Area Around Eye:
- Use a clean gauze or cloth to put direct pressure on the wound. Do this for 10 minutes to stop the bleeding.
- Wash the wound with soap and water for 5 minutes. Make sure to protect your eye with a clean cloth.
- Put an antibiotic ointment on the wound. Cover large scrapes with an adhesive bandage (Band-Aid) or dressing. Change daily.
- Treatment of Swelling or Bruise with Unbroken Skin:
- Cold Pack: For pain or swelling, use a cold pack or ice wrapped in a wet cloth. Put it on the sore area for 20 minutes. Repeat 4 times on the first day, then as needed.
- Heat Pack: If pain lasts over 2 days, apply heat to the sore area. Use a heat pack, heating pad, or warm wet washcloth. Do this for 10 minutes, then as needed.
- Treatment of Subconjunctival Hemorrhage: This is a flame-shaped bruise of the white area of eyeball. No specific treatment is needed. It most often goes away in 2-3 weeks.
- Pain Medicines:
- You can take one of the drugs listed below if you have pain.
- They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
- Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
- Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
- Do not take more than (3,000 mg) of this drug per day.
- Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
- A second choice is to take 3 pills (600 mg) every 8 hours.
- Aleve: Take 1 pill (220 mg) every 8 hours. Each pill has 220 mg of naproxen.
- A second choice is to take 2 pills (440 mg) every 12 hours.
- Use the lowest amount of a drug that makes your pain feel better.
- Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
- Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
- Caution- Acetaminophen: Do not take it if you have liver disease.
- Caution- Ibuprofen and Naproxen:
- Do not take ibuprofen or naproxen if you are pregnant.
- Do not take these drugs if you have stomach problems or kidney disease.
- Do not take these drugs for more than 7 days without checking with your doctor.
- Read all package instructions.
- Call Your Doctor If:
- Pain becomes severe
- Pain is not better after 3 days
- Changes in eyesight
- You get worse
Author: David A. Thompson, M.D.
Last reviewed: 9/1/2012
Last revised: 6/11/2013 12:29:29 PM