Eye Injuries

What to Do:

Routine Irritations
(sand, dirt, and other foreign bodies on the eye surface)

• Wash your hands thoroughly before touching the eyelids to examine or flush the eye.
• Do not touch, press, or rub the eye itself, and do whatever you can to keep your child from touching it (a baby can be swaddled as a preventive measure).
• Do not try to remove any foreign body except by flushing, because of the risk of scratching the surface of the eye, especially the cornea.
• Tilt the child's head over a basin or sink with the affected eye down and gently pull down the lower lid, encouraging the child to open his or her eyes as wide as possible. For an infant or small child, it's helpful to have a second person hold the child's eyes open while you flush.
• Gently pour a steady stream of lukewarm water (do not heat the water) from a pitcher or faucet over the eye.
• Flush for up to 15 minutes, checking the eye every 5 minutes to see if the foreign body has been flushed out.
• Because 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 afterward.
• If a foreign body is not dislodged by flushing, it will probably be necessary for a trained medical professional to flush the eye.

Embedded Foreign Body
(an object penetrates or enters the globe of the eye)

If an object, such as a piece of glass or metal, is sticking out of the eye, take the following steps:

• Call for emergency medical help or bring the child to the emergency room.
• Cover the affected eye with a small cup taped in place. The point is to keep all pressure off the eye.
• Keep your 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, flush them 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. However, do not delay flushing the eye first.

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 the 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 black eye:

• Apply cold compresses intermittently: 5 to 10 minutes on, 10 to 15 minutes off. If you use ice, make sure it's 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 him or her to sleep on the uninjured side of the 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 are noted:
  • increased redness
  • drainage from the eye
  • persistent eye pain
  • any changes in vision
  • any visible abnormality of the eyeball
  • visible bleeding on the white part (sclera) of the eye, especially near the cornea

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.

Reviewed by: Jonathan H. Salvin, MD
Date reviewed: January 2011