Having discussed eye emergencies in part 1, part 2 will address the treatment of eye conditions.
Treatment of commonly encountered conditions:
Foreign objects and corneal abrasions
The two most common causes of eye pain in the field are foreign objects and/ or corneal abrasion e.g. sand gets in the eye resulting in scratching of the cornea.
Do not rub the eye
Do not remove contacts
Try to treat immediately
Wash hands and use latex gloves if available
Know that a foreign object cannot go behind the eye, but you must look under the upper and lower eyelid. The most common place for foreign material is under the upper lid.
With a bright light find the object and determine if it is embedded in the eye, common with metal shavings, or on the surface i.e. moving about.
Try to flush out the object by putting the side of the face in a sink or bowl of water while lifting the lid and rotating the eye and alternative is to take a needle-less syringe and flush the eye with clean water.
If these fail, take a wet Q tip and try to remove the object.
With the object removed it generally takes 1-3 hours for all of the discomfort to resolve.
This appears as a bright blood layer in the white of the eye which does not extend into the colored part of the eye, the iris.
The number one cause is sneezing or something that increases pressure on the eyes. Eye trauma can cause this. Less frequent causes are taking blood thinners and aspirin or having a blood clotting disorder or low vitamin K deficiency (very rare.) Recent LASIK or cataract can also be the culprit.
If possible discontinue aspirin and blood thinners temporarily. Ice may help initially, but time is the great healer. The redness will usually dissipate in 7-10 days turning various colors like a healing bruise.
Chemicals in eye:
Flush immediately with any drinkable liquid for 15-20 minutes. The more the better. Keep blinking eyes while flushing. Do not cover or patch eyes potentially trapping corrosive chemicals.
Penetrating wounds to the eye:
If an object like a fish hook, stick, nail, etc. penetrates the eye, do not flush the eye, or put pressure on it. The idea is to keep the hole plugged until you get help. Try to keep the person calm. Tape the bottom of a paper cup, or any clean item that doesn’t touch the foreign object, over the eye. Transport to the nearest treatment center.
Conjunctivitis (redness of the eyes):
The most common causes are allergies, viral infections, and chemicals. Infectious bacterial conjunctivitis may be present if there is mucus, and/or eyelid swelling requiring antibiotic treatment. Flush eyes with Natural Tears or the equivalent. Anti-histamines may help.
Typically nothing to be concerned about if they move around in your visual field. If they persist in one spot, are accompanied by other visual symptoms, or suddenly increase, seek a medical facility.
There is usually a history of migraine. A unilateral or bilateral, throbbing headache can be preceded by a visual aura like rising heat waves, zigzags, blind spots, etc. There is often nausea and a desire to be in a dark room. A complicated version of this is seen with numbness or weakness on one or both sides of the body mimicking a stroke. Treatment consists of fluids, pain medication, rest in a dark room. The person should be evaluated medically at the first opportunity.
Link to part 1: Eye Pain – Is It an Emergency? (Part 1 of 2)
This is meant to be a field guide; not a comprehensive ophthalmological post.
Resources for further study:
National Eye Institute www.nei.nih.gov
American Academy of Ophthalmology www.aao.org/young…/top-10-eye-emergencie.
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