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Eye Injury

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Definition

  • Injuries to the eye, eyelid, and area around the eye

Types of Eye Injuries

  • Cut or Scratch of Eyelid. Small cuts heal on their own. Deep cuts or ones that go through the edge of the eyelid need sutures.
  • Bruise of the Eyelids. Also called a "black eye". The swelling and bruise get worse for a few days. Then it will go away on its own over 2 -3 weeks. It's normal for the bruise to change colors as it heals.
  • Subconjunctival Hemorrhage. This is a flame-shaped bruise of the white part (sclera) of the eyeball. It's bright red. It's caused by a scratch to the sclera. It's a mild injury that will go away on its own over 2 weeks.
  • Corneal Abrasion. A scratch of the clear part (cornea) of the eye. The cornea is the window in front of the iris. The main symptoms are severe eye pain, tearing and constant blinking. Some children will just hold their eye closed. Caused by a scratch from a branch of a tree or bush. Can also be caused by a foreign object stuck under the upper eyelid. Most are minor and heal in 2 days. This is the most common eye injury that needs to see a doctor.
  • Acute Hyphema (Serious). It means bleeding in the space between the cornea and the iris. The blood often layers out at the bottom of the cornea. It's caused by blunt trauma.
  • Punctured Eyeball (Serious). It means a sharp object has completely torn the cornea or sclera. Can happen with tiny objects thrown by a lawnmower.

Vision

  • The main concern is whether the vision is damaged.
  • Older children can tell us if their vision is blurred or out of focus. You can test this at home. Cover each eye in turn and having them look at a distant object.
  • Children less than 5 years old usually need to be examined. This is also true even if the injury seems minor. Having an exam is the only way to know the child's vision is okay.
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When To Call

Go to ER Now

  • Vision is blurred or lost in either eye
  • Seeing double or can't look up
  • Bloody or cloudy fluid behind the clear part of the eye (cornea)
  • Object hit the eye at high speed (such as from a lawn mower)
  • Nonstop tears or blinking
  • Child keeps the eye covered or will not open it
  • Severe eye pain
  • Large deep cut that will need many stitches

Call Doctor or Seek Care Now

  • Pupils not equal in size
  • Sharp object hit the eye (such as a metal chip or flying glass)
  • Skin is split open or gaping and may need stitches
  • Skin is cut and No past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
  • Any cut on the eyelid or eyeball
  • Age less than 1 year old
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Bruises near the eye
  • Dirty cut or hard to clean and no tetanus shot in more than 5 years
  • Clean cut and no tetanus shot in more than 10 years
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Minor eye injury
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Care Advice

Small Cuts, Scratches or Scrapes Treatment:

  • For any bleeding, put direct pressure on the wound. Use a gauze pad or clean cloth. Press for 10 minutes or until the bleeding has stopped.
  • Wash the wound with soap and water for 5 minutes. Protect the eye with a clean cloth.
  • For cuts or scrapes, use an antibiotic ointment (such as Polysporin). No prescription is needed. Put it on the cut 3 times a day. Do this for 3 days.
  • Cover large scrapes with a bandage. Change daily.

Swelling or Bruises with Intact Skin (including a Black Eye) Treatment:

  • Put a cold pack or ice wrapped in a wet cloth on the eye. Do this for 20 minutes. This will help stop the bleeding and swelling. Repeat as needed.
  • A black eye usually takes 1 to 2 days to occur.
  • A flame-shaped bruise of the white of the eyeball is also common.
  • After 48 hours, use a warm wet cloth for 10 minutes. Do this 3 times per day. Reason: to help reabsorb the blood.

Pain Medicine:

  • To help with the pain, give an acetaminophen product (such as Tylenol).
  • Another choice is an ibuprofen product (such as Advil).
  • Use as needed.

What to Expect:

  • Minor cuts and scratches, as well as bruises, are harmless.
  • They last about 2 weeks.
  • They do not need any medicine to help them go away.

Call Your Doctor If:

  • Pain becomes severe
  • Changes in vision
  • You think your child needs to be seen
  • Your child becomes worse

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Photos

Eye Anatomy

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Source: Self Care Decisions, LLC 2023
Self Care Decisions, LLC 2023

Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2024. Schmitt Pediatric Guidelines LLC.
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