Eye emergencies

Eye emergencies include any of the following:

BLUNT TRAUMA

• Blunt trauma to the eye or face often causes bleeding under the skin that leaves a bruise called a "black eye." The tissue around the eye turns black and blue, gradually becoming purple, green, and yellow over several days as the blood is absorbed. The abnormal color disappears within 2 weeks.
• Swelling of the eyelid and tissue around the eye may also occur. Sometimes, serious damage to the eye itself occurs from the pressure of a swollen eyelid or face.
• Certain types of skull fractures can cause bruising around the eyes, even without direct injury to the eye.
• Common causes of blunt trauma include things like fists, tennis balls, and airbags.
• Blunt trauma can cause a hyphema, which is blood inside the front of the eye. The blood may block your view of the iris and pupil.

PENETRATING TRAUMA

• Penetrating trauma may be caused by things such as knives, ice picks, sticks, nails, and gun shots.
• Injuries can be serious and usually require repair by a surgeon. Loss of the eye is not uncommon in serious injuries.
• Foreign bodies thrown at high speed by machining, grinding, or hammering are other causes of penetrating trauma.

CHEMICAL INJURY

• 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 other types of chemicals. Fumes and aerosols can also cause chemical burns.
• The cornea is the clear (transparent) tissue covering the front of the eye.
  
• With acid burns, the haze on the cornea caused by the injury 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 large amounts of clean water or salt water (saline). This kind of injury needs medical care right away.

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 become embedded in the cornea without entering the eyeball. Persistent pain, sensitivity to light, and redness are signs that treatment is needed.
• An injury to the eyelid may be a sign of a severe injury to the eye itself.

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

Eye emergencies include cuts, scratches, objects in the eye, burns, chemical exposure, and blunt injuries to the eye or eyelid. Certain eye infections and other medical conditions, such as blood clots or glaucoma, may also need medical care right away. Since the eye is easily damaged, any of these conditions can lead to vision loss if untreated.

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 when in windy and dusty areas
• Participating in sports that have a high likelihood of getting hit in the eye with a ball, such as indoor racket sports

Guluma K, Lee JE. Ophthalmology. In: Walls RM, Hockberger RS, Gausche-Hill M, Erickson TB, Wilcox SR, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 57.

Muth CC. Eye emergencies. JAMA. 2017;318(7):676. jamanetwork.com/journals/jama/fullarticle/2648633. Updated August 15, 2017. Accessed June 2, 2023.

Vrcek I, Somogyi M, Reed D, Epstein A, Durairaj VD. Evaluation and management of periorbital soft tissue trauma. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 12.9.

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.