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|Quick reference medical handouts used
by Pediatric offices
Eye Injuries in Children
injury to the eye can result from a blow, a substance or particle
blowing into the eye, an object puncturing the eye or a liquid
splashing into the eyes. The
National Society to Prevent Blindness states that about one-third of
eye loss in children younger than the age of 10 is from injury to
the eye. Parents can treat many minor eye
irritations by flushing the eye, but more serious injuries require
medical attention. When in doubt, err on the side of caution and call your child's
doctor for help.
Types of eye injuries
- Corneal Abrasions: A
corneal abrasion is a scratch or injury to the cornea, the
clear, dome-shaped surface that covers the front of the eye.
This is a very common occurrence in children. There are many
things that can cause an abrasion to the cornea. The more common
causes include foreign bodies in the eye (such as dirt, pebbles,
insects); a scratch from a toy or fingernail; contact lenses in
older children. When these objects have contact with the surface
of the eye, a small abrasion can occur.
- Chemical burns: These occur
when a child gets any type of chemical in his/her eye. Chemical
burns are a medical emergency, and the child should receive
immediate medical care. Chemical burns can result in a loss of
vision and even a loss of the eye itself, if not treated
promptly and accurately. Household cleaning agents are a common
cause of this type of injury.
- Hyphema: This refers to
blood in the anterior chamber of the eye. The anterior chamber
is the front section of the eye's interior where fluid flows in
and out, providing nourishment to the eye and surrounding
tissues. A hyphema is usually caused by a injury to the eye like
a direct hit on the eye with a rubber ball, plastic ball, tennis
ball, or with a hand or any other object. Blood is seen in the
eyeball. This is a medical emergency and immediate medical care
is necessary. Occasionally
an injury may result in retinal detachment.
- Bruising or Black Eye (Ecchymosis):
Ecchymosis, or more commonly known as a "black eye,"
usually occurs from some type of injury to the eye, causing the
tissue around the eye to become bruised. Your child's physician
will examine the eye closely to make sure there is no damage to
the actual eye itself.
- Fractures of the orbit: When
one or more bones surrounding the eye are broken, the condition
is called orbital fracture. The orbit is the bony structure
around the eye. An orbital fracture usually occurs after some
type of injury or a strike to the face. Depending on where the
fracture is located, it can be associated with severe eye injury
- Eyelid lacerations: Eyelid
lacerations are cuts to the eyelid caused by injury. Your
child's physician will examine the eye closely to make sure
there is no damage to the eye itself. An ophthalmologist
(physician who specializes in comprehensive eye care) may also
examine your child for further evaluation of the eye.
- Foreign bodies: Foreign
bodies refer to any objects that are in the eye that are not
meant to be there. The foreign object may be in the conjunctiva
(a thin membrane that covers the actual eye) or in the cornea
(the clear, dome-shaped surface that covers the front of the
immediate medical help if:
- Your child has obvious pain or trouble seeing.
- Your child has a cut or torn eyelid.
object punctures the eye
vision (seeing two of the same object).
- One eye does
not move as well as the other.
on moving the eye
- One eye sticks out compared to the other.
- The eye has an unusual pupil size or
as if something is in the eye (even if you can see nothing).
- There is blood in the clear part of the eye.
forceful blow directly to the eye
chemical substance splashes into the eye.
- Your child has something in the eye or under
the eyelid that can't be easily removed with tears or gentle
What should not be
not attempt to remove any object that has punctured the eye
not attempt to remove any particle that will not flush out with
not allow the child to rub the eye.
not put any type of ointment or drops into the eye unless
instructed to by a doctor
be done for your child:
(sand, dirt, and other foreign bodies on the eye surface)
- Wash your hands thoroughly
before touching the eyelids to examine or flush the eye.
- Do not touch,
press, or rub the eye itself, and do whatever you can to keep
the child from touching it (a baby can be swaddled as a
- Do not try to
remove any foreign body except by flushing, because of the
risk of scratching the surface of the eye, especially the
- Tilt the child's head over a
basin with the affected eye down and gently pull down the
lower lid, encouraging the child to open his or her eyes as
wide as possible. For an infant or small child, it's helpful
to have a second person hold the child's eyes open while you
- Gently pour a steady stream of
lukewarm water (do not heat the water) from a
pitcher across the eye. Sterile saline solution can also be
- Flush for up to 15 minutes,
checking the eye every 5 minutes to see if the foreign body
has been flushed out.
- Because a particle can scratch
the cornea and cause an infection, the eye should be examined
by a doctor if there continues to be any irritation afterward.
- If a foreign body is not
dislodged by flushing, it will probably be necessary for a
trained medical professional to flush the eye.
Embedded Foreign Body
Call for emergency
Cover the affected eye. If the
object is small, use an eye patch or sterile dressing. If the
object is large, cover the injured eye with a small cup taped in
place. The point is to keep all pressure off the globe of the eye.
Keep your child (and yourself) as
calm and comfortable as possible until help arrives.
(an object penetrates the globe of the eye)
Many chemicals, even those found
around the house, can damage an eye. If your child gets a chemical
in the eye and you know what it is, look on the product's
container for an emergency number to call for instructions.
Hold the child's eye
open and pour large amounts of water directly into it. This is
painful and frightening to the child but must be done because
chemicals can destroy the eye in minute
Cover the eye and go
immediately to the emergency department.
Know what splashed
into the eye and take the container with you.
Black Eye, Blunt Injury, or
A black eye is often a minor
injury, but it can also appear when there is significant eye injury
or head trauma. A visit to your child's doctor or an eye specialist
may be required to rule out serious injury, particularly if you're
not certain of the cause of the black eye.
For a black eye:
- Apply cold compresses
intermittently: 5 to 10 minutes on, 10 to 15 minutes off. If you
use ice, make sure it's covered with a towel or sock to protect
the delicate skin on the eyelid. If you aren't at home when the
injury occurs and there's no ice available, a cold soda will do
- Use cold compresses for 24 to 48
hours, then switch to applying warm compresses intermittently.
This will help the body reabsorb the leakage of blood and may
help reduce discoloration.
- If the child is in pain, give
acetaminophen - not aspirin or ibuprofen, which
can increase bleeding.
- Prop the child's head with an
extra pillow at night, and encourage him or her to sleep on the
uninjured side of his or her face (pressure can increase
- Call your child's doctor, who
may recommend an in-depth evaluation to rule out damage to the
eye. Call immediately if any of the following symptoms are
- increased redness
- drainage from the eye
- persistent eye pain
- any changes in vision
- any visible abnormality of
- visible bleeding on the
white part (sclera) of the eye, especially near the cornea
If the injury occurred during one
of your child's routine activities such as a sport,
follow up by investing in an ounce of prevention - protective
goggles or unbreakable glasses are vitally important
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
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