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Eye injuries

Eye injuries can range from relatively trivial, such as irritating the eye with shampoo, to extremely serious, resulting in permanent loss of vision.

Eye injuries can range from relatively trivial, such as irritating the eye with shampoo, to extremely serious, resulting in permanent loss of vision.

Eye injuries can occur in many settings; in the home, at work or when playing sports.

Common causes of eye injuries include:

  • something like a small particle of grit or a twig damages the transparent front part of the eye known as the cornea – this type of injury is known as a corneal abrasion
  • a foreign body such as a small piece of wood or metal gets stuck in the eye
  • a sudden blow to the eye, from a fist or a cricket ball for example, causes the middle section of the eye (the uvea) to become swollen – this type of injury is known as traumatic uveitis

Less common and more serious types of eye injury include:

  • exposure to harmful chemicals – this is known as an ocular chemical burn
  • the eye becomes cut and starts bleeding

Read more about the causes of eye injuries.

Symptoms resulting from an eye injury include:

  • eye pain – which can sometimes be severe
  • redness and watering of the eye
  • blurred vision
  • sensitivity to light

Read more about the symptoms of eye injuries.

What to do

Wash your eyes out for 20 minutes if you think they have been exposed to a chemical. Ideally, you should wash the eye with saline solution, but tap water will be fine if saline is unavailable. Use plenty of water. Water from a garden hose or water fountain is okay if you're outside.

Then go immediately to your nearest A&E department.

It's also important to go to A&E if you cut your eye and it starts bleeding or if you have something stuck in your eye. Never try to remove anything from your eye as you could damage it.

Less serious eye injuries such as corneal abrasion and traumatic uveitis do not usually require immediate medical attention. But contact your GP if your symptoms show no sign of improvement after a few days or symptoms worsen.

Read more about the treatment of eye injuries.

Complications

Complications of an eye injury are uncommon but can be serious, such as an infection taking place inside an eye after a corneal abrasion.

Read more about the complications of eye injuries.

Prevention

Not all eye injuries can be prevented, but you can reduce your risks by taking some precautions, such as:

  • wearing appropriate eyewear when carrying out tasks that could damage your eyes, such as wearing safety goggles when using power tools to grind or chisel objects
  • using good-quality sunglasses to protect your eyes from harmful ultraviolet light
  • carefully reading the labels when using household products and work in a well-ventilated area, making sure spray nozzles are pointing away from you before spraying

Read more about preventing eye injuries.


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Eye injuries

Symptoms of eye injuries include eye pain, tearing and blurred vision

Injuries to the eye can cause many different symptoms, some of the most common types are outlined below. 

Common eye injuries

Corneal abrasions

Symptoms of a corneal abrasion (where the transparent front cover of the eye – the cornea – is damaged) include:

  • eye pain
  • sensitivity to light (photophobia)
  • increase in tears produced by the eye
  • blurred or distorted vision
  • squinting caused by the muscle surrounding the eye going into spasm
  • feeling that something is in your eye and can't be removed

Uveitis

Symptoms of uveitis (where the middle section of the eye becomes swollen due to an external blow) include:

  • eye pain
  • sensitivity to light
  • deep ache in your eye, or in the brow region
  • small or irregular-shaped pupil
  • blurred vision
  • red, inflamed eye
  • increase in tears produced by the eye
  • headache

Foreign bodies

If you have something stuck in your eye, symptoms may include:

  • sensation that something is in the eye
  • increase in tears produced by the eye
  • eye pain
  • blurred or double vision
  • sensitivity to light
  • a visible foreign body on the cornea
  • if the foreign body is metal it can sometimes stain a section of the cornea – the stain is usually rust-coloured

Serious eye injuries

Chemical burn

If your eyes become exposed to hazardous chemicals (chemical burn) you may experience the following symptoms:

  • eye pain – which is often intense
  • redness of the eye
  • difficulties keeping the affected eyes open
  • swelling of the eyelid
  • blurred vision

Hyphemas and orbital blowout fractures

A hyphema describs bleeding in the front section of the eye. And a orbital blowout fracture is when one of the bones that surround the eye becomes fractured.

Both injuries usually happen together as the result of a severe blow to the face.

Symptoms of hyphemas and orbital blowout fractures include:

  • eye pain – this is often worse when moving the eyes
  • blurred vision
  • doubled vision
  • swelling and bruising around the eye

It's common to develop a black eye after this type of injury (caused by blood pooling inside the eye). The black eye can persist for several weeks.

A corneal laceration

A corneal laceration is a cut to the front section of the eye. Symptoms include:

  • eye pain, which can be particularly painful
  • tearing
  • blurred vision

When to seek medical advice

Speak to your GP immediately if you have any of the following:

  • persistent eye pain
  • foreign bodies that can't be washed out 
  • blurred and decreased vision 
  • flashing lights, spots or shapes made up of shadows in your field of vision
  • redness in the eye, particularly around your iris (the coloured part of the eye that controls the amount of light that enters)
  • pain when exposed to bright light
  • an eye injury as a result of an object hitting your eye at high speed 

Go to your nearest accident and emergency (A&E) department if your eyes have been exposed to chemicals (wash them out with water for 20 minutes first) or you have cut the front of your eye.


Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Swelling
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
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Eye injuries

Eye injuries have a number of different causes, such as: a blow to the eye – from a blunt object, a sports injury, a fall or a fight, foreign bodies

There are many causes of eye injury, including:

  • a blow to the eye 
  • foreign bodies – any material that gets into your eye, the seriousness of the injury will depend on what the object is and whether it has pierced your eye 
  • cuts to the eyelid and eyeball 
  • chemical exposure
  • ultraviolet light 

Blows to the eye

A blow to the eye can cause several injuries.

  • traumatic iritis (uveitis) – inflammation (swelling) caused by a blow to the eye 
  • orbital blowout fracture – breaks or cracks in the bones of the face that surround the eye, which can push the eyeball further back into the eye socket (orbit) 
  • bleeding in the eye (hyphema)  
  • retinal detachment – a rare condition that result from tears and breaks in the retina, and can lead to permanent vision loss if not treated

Ultraviolet light

Ultraviolet (UV) light from the sun or from exposure to sun lamps can lead to an eye injury called ultraviolet keratitis or corneal flash burn.

Contact lenses

Wearing contact lenses incorrectly can also injure your eyes.

Corneal abrasions (scratching or grazing of the cornea) are likely to occur if your contact lenses are not clean, do not fit properly or are worn for long periods of time.

It is also possible for a foreign body, such as a tiny particle of dust or dirt, to become trapped behind your contact lens and irritate your eye.



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Eye injuries

In some cases of eye injuries your GP may be able to carry out the diagnosis. But if the eye injury is more serious your GP may refer you to an ophthalmologist.

Your GP may be able to diagnose an eye injury.   

If the eye injury is serious your GP may refer you to a doctor who specialises in treating eye injuries (an ophthalmologist).

Your eyes will be examined to assess the extent of the injury. Anaesthetic eye drops may be used to numb your eye before examining it if there's any pain.

Eye examination

Your eye will be checked for a scratch or graze (abrasion) or a foreign body, such as grit or dust.

If you have an abrasion on the outer layer of your eye (cornea), eye drops containing a special dye called fluorescein might be used to stain any damaged areas, making them easier to see. A cobalt-blue filter may also be used to show up any abrasions.

If something like a foreign body is suspected, the doctor may gently turn your eyelid inside out and examine your eye using a magnifying glass.

You may be asked to look around in all directions to check whether there is any damage to your extra-ocular muscles, which connect your eyeball to your eye socket (orbit) and control your eye’s movements. You may also be asked to blink several times to check if your eyelids are working properly.

Your doctor may also shine a light into each of your eyes to assess the contraction of your pupils. To test the sharpness of your vision, you may be asked to read letters of various sizes from a wall chart (the same test used during a routine eye test).

X-rays are rarely used to diagnose eye injuries. However, if it is thought that a foreign body is stuck in your eye, an X-ray or a computerised tomography (CT) scan may be recommended.

Ruling out other eye conditions

If your eye is red, other conditions which can cause this will need to be ruled out, such as:

  • bacterial conjunctivitis – a common eye infection caused by bacteria
  • subconjunctival haemorrhage – bleeding into the whites of your eyes caused by burst blood vessels
  • ultraviolet keratitis – inflammation (swelling) of the cornea that is caused by ultraviolet light, such as from a sunbed
  • acute glaucoma – a painful condition that causes pressure in your eye and affects your vision
  • orbital cellulitis – a bacterial skin infection that can spread to your eyes 
  • iritis (uveitis) – inflammation (swelling) of the uveal tract of your eye (a group of connected structures inside your eye, including the iris)

If your GP thinks that you may have any of these conditions, they will refer you to an ophthalmologist for further assessment and treatment (if you have not been referred already). 



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Eye injuries

If chemicals are involved in the eye injury, flush your eye thoroughly using clean water or sterile fluid for at least 20 minutes.

When to see your GP

Minor eye injuries usually do not require medical treatment and should clear up by themselves.

It is recommended that you see your GP if you have:

  • persistent eye pain, or pain when exposed to bright lights
  • disturbances to your vision, such as blurred or decreased vision, or flashing lights, spots or shapes in the field of vision
  • redness in your eyes
  • foreign bodies that cannot be washed out (see below)
  • an eye injury as a result of an object hitting your eye at high speed 

Washing your eye

If you have something stuck in your eye or your eye has been exposed to chemicals, wash your eye out using a saline solution before seeking medical attention. If this is not readily available tap water will be fine.

This will dilute any chemicals and may help remove any loose material in your eye.

If chemicals are involved in the eye injury, flush your eye thoroughly using clean water or sterile fluid for at least 20 minutes. Use a lot of water to wash your eye, and gently hold your eyelids open throughout the rinsing process.

You can flush your eyes in the following ways:

  • Stand over a sink, cup your hands and put your face into the running water.
  • Hold a glass of water to your eye and tilt your head backwards (do this repeatedly).
  • If you are near a shower, wash your eye out under the running water (this is particularly useful if your eye has been exposed to chemicals).
  • If you are working outside, you can use a garden hose to rinse your eye, but make sure that it is not on a powerful flow setting.

Do not remove anything that is embedded in your eye as this could further damage the eye.
Foreign bodies should only be removed by people who have been trained to do it.

If your eye(s) have been exposed to chemicals, cover the injured eye with a clean pad after flushing. Then go straight to your nearest accident and emergency (A&E) department at your local hospital.

Treatment will depend on the type and extent of the injury. Infections from eye injuries are rare although they can be severe, so antibiotics will probably be prescribed to help prevent infection (see below).

Referral to an eye specialist

You will be referred to an ophthalmologist (a specialist in eye conditions) for treatment if:

  • Your injury was caused by a small, high-speed foreign body, such as a stone thrown up by a lawnmower.
  • Your injury was caused by chemicals getting into your eye.
  • There is a foreign body in your eye that cannot be removed by your GP.
  • You have severe pain in your eye or your vision is severely affected.
  • There may be damage to your retina (the light-sensitive layer at the back of your eye).
  • You have a deep cut in your orbit (eye socket).
  • Your eye injury becomes worse or shows no improvement.
  • You have had recurring eye injuries.

Removing a foreign body

If there is something in your eye, such as a piece of grit, your doctor may try to remove it. Anaesthetic eye drops will probably be used to numb the eye and prevent any pain.

It may be necessary to turn the eyelid inside out if it feels like the object is stuck underneath your upper eyelid.

Once the anaesthetic eye drops have worn off, your eye may feel a bit uncomfortable until the abrasion heals.

If the cells that line the outer surface of your eye are damaged, you may be prescribed eye drops (cyclopentolate) that prevent pupil spasm (involuntary contraction) and give the cells time to heal. However, cyclopentolate is not usually recommended for women who are pregnant.

Preventing infection

You may be prescribed a course of eye drops and ointment containing an antibiotic called chloramphenicol to help prevent infection. Most people will need to take the eye drops four times a day and use the ointment at night before bedtime, for seven days.

However, you may not be able to take chloramphenicol if:

  • You are pregnant or breastfeeding (or if you are trying to get pregnant).
  • You, or someone in your family, has had a condition that affects the components of your blood, such as aplastic anaemia (a lack of iron in the blood caused by toxins).

If you can't take chloramphenicol eye drops, you may be prescribed eye drops that contain fusidic acid. These should be used twice a day for seven days.

Avoid wearing contact lenses until your eye injury has completely healed to avoid irritation. If you are prescribed antibiotic eye drops, do not start wearing your contact lenses again until 24 hours after finishing your treatment.

Treating eye pain and damage

Paracetamol or ibuprofen is recommended to reduce any pain. However, ibuprofen should not be taken if you have certain medical conditions, such as asthma.

Do not take aspirin for pain relief if your eye is bleeding because this will increase the risk of bleeding.

If there is a large amount of damage to the cornea, you may be treated with eye drops as they can also prevent the muscles surrounding the eye going into spasm.

Using eye patches to cover a corneal abrasion is no longer recommended. This is because it does not reduce the healing time or reduce pain.

Treatments for uveitis (swelling of the middle section of the eye) include:

  • mydriatic eye drops – these dilate (widen) the pupil to help the eye heal
  • steroid eye drops – these help to reduce the inflammation (swelling) of the iris (the coloured part of the eye)
  • steroid tablets or steroid injections to the eye – these may be recommended in severe cases of iritis when eye drops have not been effective

Surgery

If you have a cut (laceration) on your eye, depending on the size of the injury and where it is on your eye, stitches and surgery may be required.

If the surrounding bones are fractured (an orbital blowout fracture), surgery will usually be performed one-to-two weeks after any swelling has gone down.

Follow up

In most cases, corneal eye injuries heal within a few days. Go back to your GP the day after your initial treatment to check that your eye injury is healing properly.

Your eye will be re-examined using fluorescein eye drops so that the abrasions are easier to see. You will probably need to return to your GP daily until your eye has healed fully.

However, if your eye injury hasn't started to heal after 72 hours, or if it has got worse, your GP may refer you to an ophthalmologist (eye specialist) for further specialist care.


Anaesthetic
Anaesthetic is a drug used to either numb a part of the body (local), or to put a patient to sleep (general) during surgery.
Antibiotic
Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. For example amoxicillin, streptomycin and erythromycin.
Antiseptic
Antiseptic is a substance that reduces the growth and development of germs.
Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Numb
Numbness refers to a lack of sensation in a part of the body.
Swelling
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
 
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Eye injuries

A rare and serious complication of an eye injury is that the injury makes the eye vulnerable to bacteria and an infection takes hold inside the eye

Most eye injuries are not serious, and will heal within 24 to 72 hours without any lasting damage.

However, complications sometimes occur, such as:

  • infection
  • recurring eye injuries
  • worsening symptoms

These complications are briefly discussed below.

Infection

Although rare, infections following eye injuries can be serious and need to be treated with antibiotics.

Symptoms of an eye infection include:

  • eye pain
  • sensitivity to light
  • redness of the eyes or eyelids
  • a grey or white patch develops on the coloured centre of the eye (the iris)
  • a discharge of fluid from the eye; the fluid can be yellowish-greenish or alternatively blood-stained
  • a high temperature (fever) of or above 38C (100.4F)
  • blurred or reduced vision

Seek immediate medical advice if you think you have an eye infection. Left untreated, there is a chance the infection could damage your eye(s).

Call your GP as soon as possible. If this is not possible call NHS Direct on 0845 46 47 or your local out-of-hours service.

Recurring eye injuries

In some cases, your eye may become injured again following an initial injury. This usually occurs at night when your eyes are less moistened by tears.

For example if your eye is excessively dry, the outer layer of your cornea (epithelium) can disconnect from the rest of your eye. This may require further surgery to correct.

Worsening symptoms

Sometimes, the symptoms of an eye injury can get worse.

For example, a foreign body that is stuck in your eye, such as grit, may start to penetrate or embed itself into your cornea (the transparent layer at the front of your eye).

It is also possible for a bruise to form in your eye, or for a foreign body to damage your eyelid. This is why it so important to seek immediate medical attention if you have an eye injury.



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Eye injuries

Always make sure that you wear the appropriate safety eyewear for your occupation.

Many eye injuries are preventable if you take appropriate safety precautions. The following advice can help reduce the risk of sustaining an eye injury.

  • When using household products, such as cleaning fluids and bleach, always read the labels carefully, work in a well-ventilated area and make sure any spray nozzles are pointing away from you before spraying.
  • Wash your hands thoroughly when you have finished and make sure you don't rub your eyes if you have been handling cleaning fluids.
  • Wear safety goggles while using garden equipment, such as lawn mowers, to keep your eyes safe.
  • Take care when inserting or removing contact lenses. Follow the directions for keeping them clean and sterilised, and avoid wearing them for long periods of time. Never sleep with your contact lenses in.
  • Avoid looking directly into the sun. When outdoors on sunny days, wear good-quality sunglasses to protect your eyes from harmful ultraviolet light.
  • Cover your eyes if you use a sun lamp.
  • Avoid rubbing your eyes at any time.

Safety at work

To reduce the chances of eye injuries happening at work, always ensure you follow health and safety guidelines. For example:

  • Wear safety glasses or goggles when using power tools, a hammer and when mixing or spraying chemicals.
  • Wear the appropriate safety eyewear for your occupation. For example, if using an arc welder, wear an approved face-mask to prevent sparks entering your eyes.

More information can be found on the Directgov website about health and safety at work.



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