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Quick reference medical handouts used by Pediatric offices


Eye Injuries in Children


 

An 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 include: 

  • 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 and damage.
  • 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 eye).

Seek immediate medical help if:

  • Your child has obvious pain or trouble seeing.
  • Your child has a cut or torn eyelid.
  • An object punctures the eye
  • Double vision (seeing two of the same object).
  • One eye does not move as well as the other.
  • Pain on moving the eye
  • One eye sticks out compared to the other.
  • The eye has an unusual pupil size or shape
  • Feeling as if something is in the eye (even if you can see nothing).
  • There is blood in the clear part of the eye.
  • A forceful blow directly to the eye
  • A 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 flushing.

What should not be done?

  • Do not attempt to remove any object that has punctured the eye

  • Do not attempt to remove any particle that will not flush out with gentle flushing

  • Do not allow the child to rub the eye.

  • Do not put any type of ointment or drops into the eye unless instructed to by a doctor

What can be done for your child:

Routine Irritations
(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 preventive measure).
  • Do not try to remove any foreign body except by flushing, because of the risk of scratching the surface of the eye, especially the cornea.
  • 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 flush.
  • 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 used.
  • 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
(an object penetrates the globe of the eye)

  • Call for emergency medical help.
  • 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.

Chemical Exposure

  • 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 Contusion

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 to start.
  • 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 swelling).
  • 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 noted:
    • increased redness
    • drainage from the eye
    • persistent eye pain
    • any changes in vision
    • any visible abnormality of the eyeball
    • 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 child’s pediatrician. Please read our full disclaimer.

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