Pediatric Ophthalmology Consultants

Eye Injuries

You can treat many minor eye irritations by flushing the eye, but more serious injuries require medical attention. Injuries to the eye are the most common preventable cause of blindness; so when in doubt, on the side of caution call for help.

Routine irritations (sand, dirt, and other “foreign bodies” on the eye surface)

Do not try to remove any “foreign body” except by flushing.
Wash your hands thoroughly before touching the eyelids to examine or flush the eye.
Do not touch, press, or rub the eye, and do whatever you can to keep the child from touching it (a baby can be swaddled as a preventive measure).
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 her eyes as wide as possible.
For an infant or small child, it is helpful to have a second person hold the child’s eyes open while you flush.
Gently pour a steady stream of lukewarm water from a pitcher across the eye. Sterile saline solution can also be used.
Flush for up to fifteen minutes, checking every five minutes to see if the foreign body has been flushed out.
Since 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 afterwards.
If a foreign body is not dislodged by flushing, it will be necessary for a trained medical practitioner to flush the eye.
Embedded foreign body (an object that penetrates the globe of the eye)

Call for emergency medical help
Cover the involved eye. If the object is small, use eye patches or sterile dressing for both. 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 you 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.
Flush the eye (see above) with lukewarm water for 15 to 30 minutes. If both eyes are affected, do it in the shower.
Call for emergency medical help.
Call your local poison control center for specific instructions. Be prepared to give the exact name of the chemical (if you have it).
Cover both eyes with sterile dressings, and keep them covered until help arrives.
“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 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 “simple” black eye:

Apply cold compresses intermittently: 5 minutes to 10 minutes on, 10 to 15 minutes off. If you are not at home when the injury occurs and there is no ice available, a cold soda will do to start. If you use ice, make sure it is covered with a towel or sock to protect the delicate skin on the eyelid.
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 her to sleep on the uninjured side of her face (pressure can increase swelling).
Call your doctor, who may recommend an in-depth evaluation to rule out damage to the eye. Call immediately if any of the following symptoms appear:
increased redness
drainage from the eye
persistent eye pain
distorted vision
any visible abnormality of the eyeball
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.


Credits: Journal of American Association for Pediatric Ophthalmology and Strabismus


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