Eye Injuries

Video 32 of 49
5 min 55 sec
English, Español
English, Español

Injuries to the eye can involve the eyeball, the bone, and the soft tissue surrounding the eye. Blunt objects, like a fist or a baseball, can injure the eye and/or the surrounding area. Or a smaller object could penetrate the eyeball. Care for open and closed wounds around the eye as you would for any other soft tissue injury.

In this lesson, when we talk about treating an eye injury, assume we're referring to treating an injury from an object. Near the end we'll present some information on the other type of eye injury – chemical injuries.

How to Assess and Treat Eye Injuries

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.

"Hi, my name's _____. I'm a paramedic. I'm going to help you."

Once you've ensured that the patient isn't suffering with airway, breathing, or circulation issues, the first thing you want to do is assess what type of eye injury you're dealing with – object or chemical? Both are serious!

Pro Tip #1: Eye injuries are serious and always warrant a trip to the ER, whether by calling 911 and activating EMS or by private vehicle. Therefore, the job of the responder is to stabilize the wound, stop the damage, and ready the patient for safe transport.

Sequence of Treatment for Eye Injuries

  • Sit the patient down and facing you if possible.
  • Place a small cup over the injured eye to eliminate any more damage or pressure. Ask the victim to hold the cup in place.

Pro Tip #2: If you don't have a medical grade cup, a Dixie cup is a suitable alternative. And smaller is better as you'll have tape over it.

  • Ask the patient to close their other eye and cover it with any eye bandage or a standard 4”x4” gauze pad.

Warning: Why bandage a good eye? Eyes tend to move directionally together. Leaving one eye free to roam means the other eye – the injured eye –will move as well. While also covering the good eye means neither will move.

  • Using a gauze bandage, begin wrapping over the cup and injured eye first, while asking the patient to let go of the cup. Continue wrapping around the back of the head.
  • Wrap over the gauze pad and uninjured eye, while asking the patient to let go of the pad and continue wrapping – cover the victim's head two to three times. Tuck or tape the end of the gauze to hold it in place.

Pro Tip #3: Your patient is essentially blind now. So, be extra communicative and always talk to them as you're helping them. Let them know what you're doing and why you're doing it. And keep in mind that they'll continue to need help – getting to their feet, into and out of a private vehicle or EMS vehicle, etc.

  • Make sure the victim's nostrils are free and clear of the bandage and ready the patient for transport.
  • Perform a secondary survey as you do the above. Assess the patient for secondary issues, from head to toe. And as always, continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock.

A Word About Chemical Eye Injuries

This section will mirror the last lesson on the importance of, and strategies for, diluting chemical burns. Only with the eyes, and particularly the mucous membrane, damage can occur very quickly. Meaning your quick actions are essential.

There are two types of chemical eye injuries – dry or wet. If you're dealing with dry chemicals, brush as much off the eye as you can before beginning to flush with a solution. If you're dealing with a wet chemical, go right into flushing the eye.

Pro Tip #4: Ideally, you'll have a balanced pH solution for moments like this. Otherwise, use what you have access to – tap water, bottled water, etc. Flush the injured eye for at least 20 minutes. Your goal here is to stop the damage from the chemical.

Warning: Always rinse from the inside of the eye to the outside of the eye. Flushing the eye the other way – from the outside in – could lead to cross-contamination of the other eye.

While readying the patient for transport, and during your secondary survey, make sure the victim didn't get any chemicals into their mouth, nose, ears, etc. if they did, treat accordingly.