Eye emergencies

Definition

Eye emergencies include cuts, scratches, objects in the eye, burns, chemical exposure, and blunt injuries to the eye or eyelid. Since the eye is easily damaged, any of these conditions can lead to vision loss if left untreated.

Considerations

It is important to get medical attention for all significant eye or eyelid injuries and problems. An injury to the eyelid may be a sign of severe injury to the eye itself. Many eye problems (such as a painful red eye) that are not due to injury still need urgent medical attention.

A chemical injury to the eye can be caused by a work-related accident or by common household products, such as cleaning solutions, garden chemicals, solvents, or many other types of chemicals. Fumes and aerosols can also cause chemical burns.

With acid burns, the haze on the cornea often clears with a good chance of recovery. However, alkaline substances -- such as lime, lye, commercial drain cleaners, and sodium hydroxide found in refrigeration equipment -- may cause permanent damage to the cornea. Ongoing damage may occur in spite of prompt treatment. It is important to flush the eye with clean water or saline while seeking urgent medical care.

Dust, sand, and other debris can easily enter the eye. Persistent pain and redness indicate that professional treatment is needed. A foreign body may threaten your vision if the object enters the eye itself or damages the cornea or lens. Foreign bodies propelled at high speed by machining, grinding, or hammering metal on metal present the highest risk.

A black eye is usually caused by direct trauma to the eye or face. Certain types of skull fractures can result in bruising around the eyes, even without direct trauma to the eye. The bruise is caused by bleeding under the skin. The tissue surrounding the eye turns black and blue, gradually becoming purple, green, and yellow over several days. The abnormal coloring disappears within 2 weeks. Usually, swelling of the eyelid and tissue around the eye also occurs.

Occasionally, serious damage to the eye itself occurs from the pressure of the swollen tissue. Bleeding inside the eye can reduce vision, cause glaucoma, or damage the cornea.

Causes

• Head injury
• Foreign object in the eye
• Chemical injury
• Blow to the eye
• Eyelid and eye cuts
• Conjunctivitis
• Glaucoma
• Orbital cellulitis
• Iritis
• Corneal abrasion

References

Yanoff, M, Duker, JS and Augsburger, JJ, et al. Ophthalmology. 2nd ed. St. Louis, Mo: Elsevier; 2004:1391-1396.

Auerbach PS. Wilderness Medicine. 4th ed. St. Louis, Mo: Mosby; 2001.