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Eye emergencies


Considerations:

It is important to get medical attention for all major eye or eyelid injuries and problems. Eye problems (such as a painful red eye) that are not due to injury still need urgent medical attention.

Corneal injury
Corneal injury
Causes:
  • A black eye is usually caused by direct trauma to the eye or face. The bruise is caused by bleeding under the skin. The tissue around the eye turns black and blue, gradually becoming purple, green, and yellow over several days. The abnormal color disappears within 2 weeks. Usually, swelling of the eyelid and tissue around the eye also occurs.
  • Certain types of skull fractures can cause bruising around the eyes, even without direct injury to the eye.
  • Occasionally, serious damage to the eye itself occurs from the pressure of a swollen eyelid or face. A hyphema is blood in the front area of the eye. Trauma, often due to a direct hit to the eye from a ball, is a common cause.

CHEMICAL INJURIES

  • A chemical injury to the eye can be caused by a work-related accident or by common household products, such as cleaning solutions, garden chemicals, solvents, or many other types of chemicals. Fumes and aerosols can also cause chemical burns.
  • With acid burns, the haze on the cornea often clears and there is a good chance of recovery.
  • However, alkaline substances -- such as lime, lye, commercial drain cleaners, and sodium hydroxide found in refrigeration equipment -- may cause permanent damage to the cornea.
  • Damage may occur, even with prompt treatment. It is important to flush out the eye with clean water or salt water (saline) while seeking urgent medical care.

EYELID AND EYE CUTS

  • An injury to the eyelid may be a sign of severe injury to the eye itself.

FOREIGN OBJECTS IN THE EYE AND CORNEAL INJURIES

  • The cornea is the clear (transparent) tissue covering the front of the eye.
  • Dust, sand, and other debris can easily enter the eye. Persistent pain and redness are signs that you need treatment.
  • A foreign body in the eye may threaten your vision if the object enters the eye itself or damages the cornea or lens. Foreign bodies thrown at high speed by machining, grinding, or hammering metal have the highest risk.
Symptoms:

Depending on the type of injury, any of the following symptoms may be present:

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 or any object 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.
Call immediately for emergency medical assistance if:

Seek emergency medical care if:

  • There appears to be a scratch, cut, or something has gone into (penetrated) the eyeball
  • Any chemical gets into the eye
  • The eye is painful and red
  • Nausea or headache occur with the eye pain (this may be a symptom of glaucoma or stroke)
  • There is any change in vision (such as blurred or double vision)
  • There is uncontrollable bleeding
Prevention:
  • Supervise children carefully. Teach them how to be safe.
  • Always wear protective eye gear when using power tools, hammers, or other striking tools.
  • Always wear protective eye gear when working with toxic chemicals.
  • Always wear protective eye gear when cycling or participating in sports where there is a high likelihood of injury to the eye, such as indoor racket sports.
References:

Butler FK Jr. The eye in the wilderness. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 25.

Mitchell JD. Ocular emergencies. In: Tintinalli JE, Kelen GD, Stapczynski JS, et al, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. Columbus, OH:McGraw-Hill;2006:chap 238.


Review Date: 2/7/2011
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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