How to Treat Eye Injuries: Gear and Skills

Dietrich Easter

Are you wondering how to treat eye injuries? The eyes are sensitive and vulnerable. If the eye is injured, it requires careful first aid. In this article, you'll learn the gear and training you’ll need to care for injuries to the eyes.

When treating an injury to the eye, the main concern is protection from further damage. After this, the goal is to comfortably transport the patient to the hospital. 

Let’s look at some of the most common eye injuries and how to treat them. We'll start with some of the simplest eye injuries and discuss more serious injuries as we go. 


Common Injuries to the Eyes 

The eyes are a sensitive area of the body. Any permanent injury to the eyes is a serious thing. For one, the eyes and orbital areas are prominent, so any scarring will be difficult to hide. For two, vision is one of the most important of the senses. Let's talk about eye injuries in more depth. 

Different types of eye injuries: 

  • Blunt trauma to the eye 

  • Foreign body in the eye 

  • Bleeding near the eyes 

  • Impaled object in the eyes 

  • Burns to the eyes 

  • Ruptured globe


Let's look at these in more depth. 


Blunt Trauma to the Eye 

Blunt trauma to or around the eye could result from many common things. Someone might fall and bump their head, get punched, or hit by a baseball. These injuries can often result in the common black eye, or "shiner." 

With these injuries, there's usually no bleeding and relatively little treatment. Yes, some ice can make the patient feel better. However, there's one thing you don't want to overlook. 

Don't forget about the possibility of a concussion. These types of impacts may seem less serious, but if a blood vessel ruptures within the brain, you can end up with problems. Sometimes, these symptoms don't start until a day or two. You might notice the patient has a worsening headache, nausea, or changes in behavior. If you notice any of these things, it's best to contact the ER. 

Tools to treat blunt force trauma around the eyes: ice packs and penlights (for checking pupils - they should be equal and reactive to the light). 


Foreign Body in the Eye 

A foreign body in the eye could be something as simple as sand or something more sinister like a splinter. Many times, the eye will begin to tear up, naturally flushing out the substance. However, if there's a lot of gunk that's found its way into the eye, then it's important to remove as much as possible. 

What types of things get caught in the eye? Lots. But some of the most common might be sand, chemicals at a worksite, or sawdust and flying woodchips from carpentry or home improvement jobs. 

Each of these things will be treated a little bit differently. However, there is a guiding principle for each injury: flush the eye with sterile water or saline. This is the best way to remove a foreign substance from the eye. 

Here are some things to know about flushing the eye: 

  1. Safety. If the substance in the eye is a chemical, make sure that the rescuers are careful not to get the substance on their bodies. 

  2. Flush from the center. Flush the eyes with water so that the water is flowing away from the other eye. You don't want to just flush the substance from one eye into the other eye! This would create more problems!

  3. Repeat as needed. The patient may only be able to tolerate so much water at one time. However, if there is still gunk in their eye, they should be encouraged to continue flushing the with water. 

  4. Careful with some chemicals. If the person had a chemical in their eye, try your best to identify the chemical before flushing with water. Some chemicals will react with water and create heat, causing burns. 


Note that getting some substance in your eye is very different than having an object, like a pencil, impaled in your eye. We'll talk about how to treat an impaled object in a little bit. For now, let's address bleeding near the eye. 


Bleeding Near the Eye 

The eye is a soft structure. However, the eye is protected by the eye socket, which is a construction of bones often known as the orbital bones. These bones are rather sharp, particularly the eyebrow, making it easy to split the eyebrow open. 

To control bleeding around the eye, you do the same thing you would do anywhere else on the body: hold pointed, firm, direct pressure for at least 10 minutes - especially if it's a major bleed. Don't peak at the injury; just hold pressure. 

Bleeding from the face usually looks severe; however, don't panic. Just apply pressure. 

There are some relatively large arteries on the side of the forehead, just behind the eye. Make sure you're applying pressure in the right spots and controlling these bleeds. For these types of eye injuries, you'll need some gauze to apply pressure to the wound. However, you can apply pressure with your hands. 

Now, let's talk about impaled objects in the eye. 


Impaled Object in the Eye 

Yes, these are gruesome injuries, but they happen: objects do become impaled in the eye. These could be small objects, like a large splinter, or larger objects, like a knife or a pen. Regardless, these injuries must be treated with care. 

How do you treat such an injury? Well, these emergencies require surgery for treatment. There's not much to be done in the field to fix the problem. Do not pull the object from the eye! This is a standard rule for an impaled object. Leave it in place, stabilize the object, and carefully transport the patient to the ER (call 911 and get an ambulance coming!). 

Why shouldn't you remove impaled objects from the eye? There are multiple reasons (and some exceptions!). 

First, you can cause more injury by yanking out an impaled object. Second, you can cause more bleeding. Sometimes, the object will be pressing against an open bleed vessel, essentially holding pressure. 

However, if there's profuse bleeding, you can still hold pressure around the object (if it's in a leg or something). And, if there's arterial bleeding, you can still apply a tourniquet above the injury. 


Exceptions: you CAN remove an impaled object if it's impeding CPR or rescue breathing. The airway and chest compressions are the two times you can remove an impaled object. 


Steps to treat an impaled object in the eye: 


  1. Stabilize. You can use a Styrofoam cup with the center punched out to secure the object. Then use some gauze to wrap gently around the wound. 

  2. Rolled gauze. You can roll some gauze up and pad around the object, stabilizing it. Again, be careful not to put any pressure on the object. 

  3. Cover both eyes. Even if only one eye is injured, you may choose to cover both eyes. This will help the patient refrain from moving both eyes. Of course, in some instances (if the patient needs to navigate their own evacuation or they're anxious about having their eyes covered), you should leave the eye uncovered. 


Tools you'll need for this: rolled gauze and medical tape

Now, let's talk about burns to the eyes. 


Burn to the Eye 

A burn to the eyes is a scary thing. If someone has sustained burns to the eyes, you should take time to flush the eyes with water or sterile saline. You need to stop the burning process. 

Though burns to the eyes are devastating, they are not the most dangerous possibility. If someone was seriously burned to the face, then they could have airway burns. Any burns to the nose, mouth, or throat could become an immediate life threat. The tissue in the mouth and throat can rapidly swell, closing off the airway and suffocating the victim. 

So, as bad as burns to the eyes are, and they should be treated, don't let these burns distract you from the more serious possibility of burns to the airway. 


Ruptured Globe 

The eye is full of a liquid, and it can rupture. How do you treat this? Well, there's not much you can do in the field. However, with good surgical intervention, physicians might save the eye. Your job as a responder is to protect the eye from further harm. 

One of the best ways to protect the eye is with an eye shield. These are semi-rigid structure that rests over the eye and is held in place with a bandage. Again, like with an impaled object, you may want to cover both eyes to help the patient resist the urge to move both eyes simultaneously.  

Tools needed: eye shield and gauze


Here's the last thing you need to know about eye injuries: it's much better to prevent them than to treat them! Take some time to watch this video on good safety glasses. Always go the extra mile to protect your vision!