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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. Swelling of the eyelid and tissue around the eye may also occur.
  • Certain types of skull fractures can cause bruising around the eyes, even without direct injury to the eye.
  • Sometimes, 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 is a common cause and is often due to a direct hit to the eye from a ball.

Chemical injuries

  • A chemical injury to the eye can be caused by a work-related accident. It can also be caused 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.
  • Alkaline substances -- such as lime, lye, drain cleaners, and sodium hydroxide found in refrigeration equipment -- may cause permanent damage to the cornea.
  • 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 object 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, sensitivity to light, and redness are signs that treatment is needed.
  • A foreign body in the eye may threaten 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 of injuring the eye.
Symptoms:

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

Do Not:

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 promptly.
  • Do not use cotton swabs, tweezers, or anything else on the eye itself. Cotton swabs should only be used on the eyelid.
When to Contact a Medical Professional:

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
  • Working with toxic chemicals
  • Cycling or participating in sports where there is a high likelihood of injury to the eye, such as indoor racket sports
References:

Henley GW. Eye emergencies. In: Wolfson AB, Hendey GW, Ling LJ, Rosen CL, eds. Harwood-Nuss’ Clinical Practice of Emergency Medicine. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 54-61.

Sharma R, Brunette DD. Ophthalmology. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Elsevier Mosby; 2009:chap 69.


Review Date: 5/9/2013
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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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