Eye injuries

Also known as eye trauma

Eye injuries can be caused by a direct blow, something getting into your eye, flash burns or chemical burns.

Key points about eye injuries

  1. Symptoms of eye injuries depend on the causes.
  2. Minor eye injuries can be treated at home – see self-care for minor eye injuries
  3. More serious eye injuries need medical attention – see first aid for eye injuries and when to seek urgent medical attention
  4. Most eye injuries are preventable. Wear safety glasses or protective goggles if there is any risk to your eyes. 

Seek medical care immediately if you:

  • get a strong chemical such as oven cleaner and bleach in your eye
  • receive a blow to the head that causes you to have double vision, difficulty moving your eye, severe headache, nausea or vomiting. See also head injuries
  • have something pierce (go into) your eye
  • have blurred vision or lose vision in the affected eye
  • develop sensitivity to bright light
  • have blood or pus coming out from the affected eye
  • can't move your eye or keep it open
  • have a black or swollen eye
  • have eye symptoms that don't settle after washing your eyes for 15 minutes.

What are the causes of eye injuries?

Common causes of eye injury include the following:

Chemical burns – exposure to strong chemicals, such as oven cleaner or bleach.
Corneal abrasion – scratch to the front of your eye.
Foreign body – an object that shouldn't be in your eye, such as a piece of glass, dust, seed, wood chips or a sharp object. A foreign body can cause injury to your eye by scratching the cornea or penetrating (going into) the eye.
A direct blow to your eye – a strike to your eye by hard or sharp objects, such as a baseball, fist or metal. This can injure the contents of your eyeball or surrounding structures such as the eyelid or the bones around your eye (orbit).
Flash burns – damage to the cornea caused by exposure to bright ultraviolet light from sources such as a welding torch, direct sunlight, a sunlamp in a tanning salon or a reflection of the sun off snow.

What are the symptoms of eye injuries?

Symptoms of eye injuries depend on the causes. 

  • Symptoms of a chemical eye injury include a sudden painful watery red eye after you've been exposed to chemicals. There may be a delay in symptoms if you've been exposed to a noxious (toxic) gas. 
  • Symptoms of corneal abrasion and corneal foreign body include a severely painful, watery and red eye with increased light sensitivity. Your vision may be hazy if the abrasion is central. 
  • The symptoms of blunt trauma can range from the appearance of a sunken eye or a protruding eye, double vision, pain, blurred vision, bruising and red eye. 
  • If you have sudden loss of vision when you've been doing something involving a small object moving quickly eg, hammering metal on metal, you may have had your eye pierced.
  • Symptoms that you have broken the bones around your eye include double vision, with or without pain, but still being able to move your eye.

How are eye injuries diagnosed?

You can seek eye care from your GP, emergency clinic, optometrist or an ophthalmologist. Most eye injuries are covered by ACC. 

Your eye care provider will ask you specific questions related to your injury, including how the injury happened and what object(s) was involved. 

Diagnosis requires an eye examination, which may include:

  • measuring your vision
  • anaesthetic drops – numbing drops so your eye can be examined
  • inspection with specialised instruments – ophthalmoscope and slit lamp exam
  • putting orange dye in your eyes, which reveals damage to the front of your eye – the dye is harmless and washes out with your tears
  • x-rays or CT scans.

How are eye injuries treated?

Treatment of eye injuries depends on the nature and extent of injury. Follow the specific instructions of your eye care provider, as different eye injuries require different treatment. You may need to be referred to an ophthalmologist (a doctor with specialist training in assessing and treating eye conditions) depending on how severe the injury is. 

The treatment of eye conditions includes the following:

  • Dilating drops to relax your eye muscles and, hence, reduce pain. Your pupils (the black part of the eye) will look bigger than normal for a few days.
  • Eye pad/dressing – your eyes may be padded to allow healing. Don't drive with an eye patch on.
  • Eye drops/ointment – note how often to use the prescribed eye drops or ointment.
  • Follow-up – you may be reviewed in 24–48 hours to make sure that your eyes are healing as some conditions such as infection may be delayed in onset.
  • Pain-relieving medication such as paracetamol, ibuprofen or codeine.
  • Sunglasses if your eyes are sensitive to light.
  • Artificial tears or lubricants to help any discomfort in your eyes.

First aid for eye injuries

Direct blow to your eye

A blow to your eye can damage the eye and its nearby structures. Place an ice compress on your eye immediately for 15 minutes to reduce pain and swelling. This could be a bag of frozen peas or commercially available ice packs. 

Seek medical attention if you have symptoms of reduced vision (as this may indicate a bleed within the eye), pain on eye movements or double vision (as this may suggest a fracture of the bones around the eye), if the eye appears sunken (suggestive of fracture) or more prominent (suggestive of blood or air behind eye) or if there is significant swelling of the eye. 

Chemical burn to your eye

If your eye comes into contact with any strong chemicals, such as oven cleaner and bleach, follow these steps immediately:

  • Flush your eye with running clean water (not hot) for at least 15 minutes.
  • Hold your eye wide open with your fingers and make sure all surfaces of your eyeball are flushed.
  • Then go to the nearest emergency department immediately.
  • Bring the chemical container with you if possible or take a picture of its ingredients.

Treatment of eye injuries depends on the cause. Follow the specific instructions of your doctor, as different eye injuries require different treatment. You may need to be referred to an ophthalmologist (an eye specialist) depending on the severity of the injury. 

Something in your eye

If you suspect something has flown or penetrated your eye, protect the eye with a pair of glasses or sunglasses and ask someone to take you to the nearest emergency department immediately. The object may need removal surgically by an ophthalmologist.

  • Do not try to remove an object that has pierced or penetrated your eye yourself and do not rub your eyes. 
  • Do not have anything to eat or drink until you are assessed by a doctor, as you may require urgent surgery.
  • Check your tetanus status, and get a booster injection if needed.

Flash burn or light radiation to your eye

If you are exposed to bright light or high ultraviolet light and experience symptoms of discomfort, reduced vision, red eye and light sensitivity, you may be experiencing a flash burn to your eye (also known as arc eye). See your eye care provider for assessment. You may also be given a mild steroid-based anti-inflammatory drop to manage your condition. 

Self-care for minor eye injuries

In general, follow these steps to remove something small or minor from your eye such as an eyelash, a piece of dust or an insect:

  • Do not rub your eyes.
  • Wash your hands before touching your eye.
  • Look in a mirror to see the object in your eye.
  • Blink to allow your tears to wash the object out of your eye.
  • Hold your eye wide open using your fingers and roll your eyeball.
  • Use a wet cotton swab or a clean cloth to remove floating particles or eyelash.
  • Rinse your eye with plain water using an eye cup or a small glass to flush the object out.
  • Do not remove any object that has pierced, penetrated or is stuck in your eye.

How can I prevent eye injuries?

Most eye injuries are preventable.

  • Wear safety glasses whenever there is any risk of danger to your eyes, such as when drilling, sawing, handling strong chemicals and gardening.
  • Wear protective goggles if your workplace has any risk of danger to your eyes, such as if you handle cement, plaster dust or glass.
  • Wear specialised ultraviolet protection when there is a lot of light radiation, such as when welding or skiing.
  • Wash your hands regularly before touching your eyes.
  • Wear eye guards when playing sports such as squash or baseball. 

General suggestions for using eye drops and ointments include to:

  • wash your hands before touching your eyes
  • rest your finger on your cheek and pull down the lower eyelid
  • tilt your head back and drop the liquid into your lower eyelid
  • for ointment, smear a small amount (1mm strip) along the inside of your lower eyelid
  • make sure that the nozzle doesn’t touch your eye
  • keep all drops and ointment in the fridge and out of reach of children.

If you are prescribed eye drops or eye ointments, you can also ask your doctor or pharmacist about using eye drops or eye ointments correctly. 

Where to get help for an eye injury:

  • In an emergency, call 111
  • Your doctor
  • Emergency department of your nearest hospital
  • Ophthalmologist
  • Optometrist

Learn more

Eye injuries Ministry of Health, NZ 
Eye injuries St John, NZ
Corneal injury and foreign bodies Patient Info, UK 
Eye injuries NHS, UK 

References

  1. Trauma in eyes Auckland Regional HealthPathways, NZ, 2020
  2. Foreign body in eye Auckland Regional HealthPathways, NZ, 2020
  3. Corneal injury and foreign bodies Patient Info, UK
  4. The Wills Eye Manual: Office and emergency room diagnosis and treatment of eye disease (7th ed.) Lippincott Williams & Wilkins, 2016

Reviewed by

Dr Perumal works at the Eye Institute and Auckland public hospital. She has expertise in performing eye surgery, including advanced glaucoma surgery and cataract surgery. She is a senior lecturer at the University of Auckland and is actively involved in teaching junior doctors and research, as well as conducting public lectures. 
Credits: Health Navigator Editorial Team. Reviewed By: Dr Divya Perumal, ophthalmologist, Auckland Last reviewed: 11 Sep 2020