The eye, by receiving light, transmits sensations to the brain. We are then able to see the world around us.
The casualty with an eye injury may be worried and distressed because almost every eye injury carries the threat of permanent damage or even blindness. The eye is particularly susceptible to infection. Whenever practicable, wash your hands thoroughly before inspecting or treating eye injuries, to reduce this risk.
Eye injuries are caused by:
- Foreign bodies lodging in the eye.
- Penetrating objects.
- Direct blows.
- Burns from chemicals.
Foreign Bodies In The Eye.
The most common foreign bodies to lodge in the eye are loose lashes, insects and particles of grit, metal and glass.
Look for any foreign bodies in the casualty’s eye by examining the eye and its surroundings.
- Ask the casualty what happened.
- Look around for any obvious cause, for
- Example grindstone, shattered glass, etc.
- Pain in the eye, particularly on looking at light
- Irritation and/or soreness.
- Inability to open the eye.
- Tears or weeping of the eye.
- Spasm or twitching of the eyelids.
- Redness of the eye.
- Sensitivity to light.
- Warn the casualty not to rub the eye, as this may aggravate the injury.
- Never try to remove a foreign body from the window of the eye (cornea).
- Never try to remove any object embedded in the eye.
- If the foreign body moves away from the cornea, it is safe to remove it.
For embedded foreign bodies or penetrating wounds to the eye:
- Lay the casualty on a stretcher, if available.
- Pad both eyes, making sure that the dressing does not press on the injured eye by placing thick pads under the dressing, above and below the eye.
Small loose foreign bodies are often washed out by tears. If not:
- Get a wisp of cotton wool or the corner of a clean handkerchief moistened with cold water.
- Sit the casualty in a good light — a light source to the side of the eyeball makes the foreign body easier to see.
If the injury is thought to be severe, do not examine the eye, as this may lead to the contents of the eye being squeezed out through any cut in the eyeball.
Examine The Lower Lid.
- Instruct the casualty to look up.
- Gently draw the lower lid downwards and away from the eyeball to expose the foreign body, and, if seen, remove with cotton wool or a handkerchief corner
Examine The Upper Lid.
- Instruct the casualty to look down then gently grasp the eyelashes of the upper lid.
- Pull the upper lid downwards and forwards over the lower lid; this may dislodge the foreign body, if it does not, then.
- Irrigate the eye with a gentle stream of clean water.
Evert The Upper Lid.
Place a smooth matchstick or stem of a cotton applicator at the base of the upper lid.
Press it gently backwards, then — instruct the casualty to look downwards.
Take hold of the lashes of the upper lid and pull up and over the matchstick or applicator stem and so evert the eyelid.
If the foreign body cannot be wiped away from the under surface of the eyelid, send the casualty to hospital.
Burns To The Eye.
These may be due to:
- Arc flash.
These are often caused by corrosive chemicals:
- Caustics, for example strong alkalis such as caustic soda, lime, etc.
Heat burns are often the result of naked flame or radiated heat.
Most often, flash burns are work-related injuries caused by both eyes being exposed to the light from arc welding while unprotected.
During an eclipse of the sun burns to the back of the eye (the retina) can occur if the eclipse is observed without using adequate screening.
Assessment Of The Casualty.
Obtain a history of the incident and look for the following symptoms and signs.
Seek the possible cause by questioning the casualty or bystanders to find out what happened.
Symptoms And Signs.
- Usually severe watering of the eyes.
- Spasm of the eyelids.
- Reddening of the eyeball.
- When the eyelids are involved, marked swelling.
- In the case of flash burns, often a feeling of grit in the eyes, the onset of which may be delayed for several hours; onset of pain may also be delayed.
Management Of Burns To The Eye.
Corrosive Or Heat Burns.
In the case of corrosive burns to the eyes, immediate action is necessary to prevent further damage.
- Open the eyelids with your fingers.
- Irrigate the eye freely and continuously with cold flowing water for about 20 minutes, ensuring that you irrigate under the eyelids.
- Place an eye-pad or light clean dressing over both eyes.
- Seek medical aid.
- Cover the affected eyes with eye pads or clean material.
- Seek medical aid.
To Irrigate The Eye.
- Instruct the casualty to incline the head to the affected side with the neck extended.
- Hold eyelids apart with the thumb and index finger of one hand; this is easier if the casualty tries to open the other eye.
- Using tap water, gently pour a stream of water into the inner corner of the eye.
- Continue irrigation for 20 minutes or until medical aid arrives.