Primary Management of Eye Trauma

Despite the fact that Eye trauma or injuries and foreign bodies in the eye are preventable, they are still major causes of ocular morbidity and blindness. Eye trauma demand urgent attention to avoid complications. However, appropriate management will reduce the social and economic impact on the society particularly the under developed and developing nations. Aside from the under listed specific measures, preventive-focused health education is the best means of management at the grassroots level.

1.      Foreign body in the eye

      The object may be conjunctiva, corneal or sub-tarsal, that is under the upper eyelid and causes sensation. On assessment, vision is usually normal but if central corneal is involved vision may be impaired. On physical examination, the foreign body is seen on the conjunctiva or cornea under the eye lid.

Management

•             Wash any loose foreign body away with clean water.

•               If the foreign material is sub-tarsal or conjunctiva, remove with clean cotton bud. However if it is corneal use local anesthetic first and then carefully remove it with the corner of a paper.

•             Apply antibiotic eye ointment.

•               Refer to ophthalmologist if the foreign body cannot be removed.

2.      Burns

Burns to the eye may be as a result of acid, alkali or thermal injury. Burns of these nature usually affect vision. Physical examination may reveal red eyes and hazy cornea.

Management

•             As quickly as possible, wash the eyes with clean water for 15 minutes.

•               Apply antibiotics eye ointment.

•               Give analgesics (pain relief) drugs.

•               Urgently refer to eye clinic.

3.      Penetrating injury

Penetrating injury is majorly caused by sharp objects as a result there is perforation of the coat of the eye, that is, cornea or sclera. Vision is usually impaired, the cornea appears hazy and the pupil may be distorted with uveal prolapse.

Management

•             Carefully apply an eye pad ensuring that the affected eye is not pressed unduly.

•             Give tetanus toxoid 0.5ml immediately.

•             Urgently refer to an eye clinic.

4.      Blunt injury

 This refers to eye injury caused by blunt object e.g. fist.  Anterior chamber hyphaema, a condition in which the front of the eyes becomes filled with blood occurs. Vision is also reduced while the pupil may be dilated.

Management

•             Apply an eye pad to the affected eye to prevent the person from rubbing the eye.

•             Give pain relief drug that does not contain Aspirin because Aspirin hinders the coagulation of blood. The presence of blood in the eye means that there is rupture of blood vessels and if coagulation does not take place, blood will continue flow into the eyes.

•               Observe bed rest.

•             If vision is reduced, or there is more bleeding inside the eye, or the eye becomes more painful, refer immediately.

5.      Lid Laceration

Tear of the Canaliculus or eye lid margin. Vision is not affected

Management

•               Hold the torn skin in place with sterile gauze pad.

•             Give analgesics

•             Refer to eye unit for surgery to ensure the alignment of the lid margin.

The eyes is one of the delicate and sensitive organs of the body. It is a vital organ that must be jealously taken care of. Ensure that adequate preventive measures are taken to avoid injury to the eyes.