S05.9+(Y34.99)
DESCRIPTION
Eye injuries can be caused by high speed flying objects e.g. pieces of wood, glass, stone and other materials or by blunt trauma e.g. sporting balls, blow from a fist, facial trauma in a MVA. Injuries include conjunctival/corneal lacerations, haematoma, orbital fracture and penetrating open-globe injuries with prolapse of eye contents.
Check for:
- visual loss, hyphema, lacerations
- perforation e.g. teardrop-shaped pupil indicating uveal prolapse
- muscular entrapment associated with a fracture of the orbital bones limiting vision in one direction
GENERAL MEASURES
- Apply an eye shield only. Avoid using pressure patching which increases the risk of intraocular infection.
MEDICINE TREATMENT
Deep corneal or scleral injuries:
Cover with an eye shield and refer immediately.
If immediate referral is not possible, while awaiting transfer:
- Atropine, 1%, drops, instilled immediately.
- Chloramphenicol 1%, ophthalmic ointment applied immediately.
Pain:
Children
- Paracetamol, oral, 10-15 mg/kg/dose 6 hourly when required. See Paediatric dosing tool.
Adults
- Paracetamol, oral, 1 g 4–6 hourly when required.
- Maximum dose: 15 mg/kg/dose.
- Maximum dose: 4 g in 24 hours.
CAUTION
Review the problem daily.
Do not use an eye pad if there is ecchymosis, lid oedema or bleeding.
REFERRAL
Immediately:
- If the foreign body cannot be removed or an intraocular foreign body is suspected.
- Laceration, perforation or diffuse damage to the cornea or sclera.
- Damage to other structures of the eye, including the eyelid edge.
- Visual abnormalities or limitation of movement of the eye.