DESCRIPTIONInjuries to the eye include contusions and fractures of bones that form the eye socket or orbit, contusions and lacerations of the eyelids, and abrasions of the cornea (the transparent covering of the pupil of the eye) or other injury to the eyeball. The bones that form the orbit; the eyelids; the eyeball including the cornea, conjunctiva (white of the eye), iris (colored part of the eye), and aqueous humor (fluid in the eyeball); and the muscles, tendons, periosteum (covering of the bone), nerves, blood vessels, skin, and connective tissue in the vicinity of the eye are also involved. Appropriate health care includes doctor's treatment; emergency room care; hospitalization for repair of facial bones (sometimes).
SIGNS & SYMPTOMSInjury to the orbit: pain; swollen lids; protruding eyeball if bleeding occurs in back of the child's eye; numbness around the eye; inability to move the eye normally; decreased vision.
Injury to the lids: pain; a cut, laceration, or contusion with swelling, redness, tenderness, pain, bleeding, or bruising ("black eye") in or around the child's eye; a change in the child's ability to see clearly.
Injury to the eyeball: eye pain; sensitivity to bright light; eyelid spasm; tearing; blurred vision; redness in the white of the eye; irregular size of the pupils.
Direct blow in the vicinity of the child's eye; irritation from many different materials, such as pesticides on plants or gravel or dust; a foreign body imbedded in the eye; scratching of the cornea.
Contact sports such as football or soccer; racket sports; windy weather; rough terrain for workouts or competition.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should wear a face mask or protective glasses for sports and should avoid allergens, if possible.
Medical history and physical exam by an ophthalmologist or cosmetic surgeon.
X-rays of the child's skull and facial bones to detect possible fractures.
POSSIBLE COMPLICATIONSInfection, especially when imbedded foreign bodies are not completely removed from the child's cornea; permanent (sometimes total) loss of vision if infection penetrates the eyeball from the cornea; bleeding into the eye as a result of a blunt injury; scarring if eyelid lacerations are unattended.
Cornea injury with infection: This serious eye problem is usually curable in 2 to 3 weeks with special care from an ophthalmologist. Eyelid injury: Eyelid lacerations usually heal in 1 to 2 weeks if they are carefully closed surgically by a specialist in plastic surgery. Orbit (bone) injury: Facial surgery by a cosmetic surgeon usually improves appearance. Bones require 6 to 8 weeks to heal. Injuries due to foreign bodies: These injuries heal easily if the foreign body is removed and antibiotic medication is used to fight infection.
Don't try to remove the child's contact lenses. Don't rub the eye. Don't wash the eye. Cover both eyes with loose cloth pads. (Both eyes must be covered to prevent movement of the injured eye.) Apply crushed ice in a soft cloth bag or a towel -- not a heavy ice bag. Avoid any pressure on the eye.
After emergency treatment: Protect eyes from bright light or sunlight by having the child wear dark glasses. Use ice packs or warm water compresses, wrung out slightly, to relieve discomfort. The child should sleep with the head elevated with 2 pillows until symptoms subside. Urge the child not to rub the eye.
For lacerations after suturing: Keep the child's wound dry and covered for 48 hours. If you change the bandage, apply a small amount of petroleum jelly or non-prescription antibiotic ointment to each new bandage. After 48 hours, replace the bandage if it gets wet. Ignore small amounts of bleeding. Control heavier bleeding by firmly pressing a facial tissue or clean cloth to the bleeding spot, avoiding pressure on the eyeball itself.
Your doctor may prescribe antibiotic eyedrops or ointment to prevent infection; pain relievers; local anesthetic eyedrops or drops to dilate the pupil and rest the eye muscle.
Your child can resume normal activities gradually after treatment.
DIET & FLUIDS
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has a foreign body in the eye or a cut or other eye injury; the following occurs during or after treatment: pain increases or does not disappear in 2 days; the child's vision changes; the eye does not move up and down normally; there is a fever over 101F (38.3C); the child experiences pain that is not relieved by acetaminophen.