Eye Trauma

Overview

Eye trauma refers to any injury affecting the eyeball, eyelids, eye socket, or the surrounding tissues. It ranges widely in severity, from a minor irritation caused by a speck of dust to a serious wound that can permanently damage sight. Because the eye is delicate and many injuries can worsen quickly, it is safest to treat eye injuries with caution and seek professional care when there is any doubt.

Many eye injuries happen at home, at work, or during sports. Common examples include scratches to the surface of the eye (corneal abrasions), foreign objects, blunt blows, and chemical splashes. Wearing protective eyewear during risky activities prevents a large share of these injuries.

Symptoms

Symptoms depend on the type and severity of the injury, but may include:

• Eye pain, a gritty feeling, or the sensation of something stuck in the eye
• Redness, watering, or swelling of the eye or eyelid
• Blurred vision, double vision, or sudden loss of vision
• Sensitivity to light
• Bleeding within the eye or visible blood over the white of the eye
• An abnormally shaped or fixed pupil, or trouble moving the eye

Seek emergency care immediately if there is a penetrating object, a chemical splash, sudden vision loss, severe pain, blood pooling inside the eye, or an obvious wound to the eyeball.

Causes

Eye trauma can be grouped by the mechanism of injury:

• Foreign bodies and scratches: Dust, sand, metal shavings, or fingernails can scratch the cornea or lodge under the eyelid.
• Blunt injury: A ball, fist, or other object striking the eye can bruise it, cause bleeding inside the eye, or fracture the bones of the eye socket.
• Penetrating or perforating injury: Sharp objects or high-speed fragments can cut into or pass through the eyeball.
• Chemical burns: Acids, alkalis, and household cleaners can rapidly damage the eye surface. Alkali burns are especially dangerous.
• Radiation and heat: Welding flashes, ultraviolet light, and flames can burn the eye surface.

Risk Factors

• Working with power tools, metal, chemicals, or wood without eye protection
• Playing contact or racquet sports without protective goggles
• Handling fireworks or using cleaning chemicals
• Construction, manufacturing, and agricultural work
• Being a young child, who may not anticipate hazards

Diagnosis

A clinician examines the eye and the structures around it, checks vision, and looks for foreign bodies, cuts, or bleeding. Tools and tests may include:

• Visual acuity testing to measure how well each eye sees.
• Slit-lamp examination with a special microscope and light to inspect the eye surface and interior.
• Fluorescein dye, which highlights scratches on the cornea.
• Imaging such as a CT scan when a fracture or a foreign object inside the eye is suspected. MRI is avoided if a metal foreign body is possible.

Treatment

Treatment depends entirely on the injury. General principles and common approaches include:

• Chemical splash: Immediately flush the eye with clean water or saline for at least 15 to 20 minutes, then go to emergency care. Prompt rinsing is the single most important step.
• Foreign body: Small surface particles may be flushed out; embedded objects are removed by a professional. Never try to remove an object stuck in the eyeball.
• Corneal abrasion: Often heals within a few days with lubricating or antibiotic drops to prevent infection.
• Blunt injury: May require monitoring for bleeding inside the eye and treatment of any socket fracture.
• Penetrating injury: Cover the eye loosely with a shield (not pressure), avoid pressing on it, and seek emergency surgical care.

Do not rub the eye, apply pressure, or try to remove a deeply embedded object yourself, as these can worsen the damage.

Prevention

• Wear safety glasses or goggles for DIY projects, yard work, and any task with flying particles
• Use sport-specific protective eyewear for high-risk sports
• Follow safety instructions when handling chemicals and store them out of children's reach
• Keep sharp objects and fireworks away from children
• Use proper shielding when welding or working with intense light

When to See a Doctor

Seek emergency care right away for any of the following:

• A chemical splash to the eye (rinse first, then go)
• An object stuck in or piercing the eye
• Sudden vision loss, double vision, or severe pain
• Bleeding inside the eye or a cut to the eyeball
• A misshapen pupil or inability to move the eye

For minor irritation or a small scratch that does not improve within a day or two, or if redness and pain increase, see an eye care professional.

Related Topics

Frequently Asked Questions

References

1. American Academy of Ophthalmology. Eye injuries.
2. Mayo Clinic. Eye injury: first aid.
3. National Eye Institute (NEI).
4. MedlinePlus, U.S. National Library of Medicine. Eye injuries.