Eye injuries

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Eye injuries include cuts, impact injuries, foreign objects entering the eye, a chemical or other substances in the eye. First, if possible, ask the patient to remove their contact lenses if they are wearing them. If the patient has a substance in their eye, for example, a chemical, you will need to wash it out carefully. Care should always be taken to wash away from the unaffected eye to avoid rinsing the chemical into the good eye. Ask the patient to turn their head to one side and wash the chemical out. Use a saline solution, an eyewash station, or clean water. You will need to make a note of the chemical so that you can pass this information on to the emergency medical services. If you can provide a label of the chemical or a datasheet, send this with the patient to the hospital. With chemicals, you need to ensure the substance has been fully removed from the eye and the recommendation is to flush the eye for at least 20 minutes. Small particles like grit, sand, or dirt can be blinked out, washed out, or removed from the eye very carefully with the corner of a sterile dressing or a tissue.

If there is any chance that the eye itself has been scratched, then this should be checked out by a medical professional. With cuts around the eye, you can apply a sterile eye pad dressing. With this type of injury, you should reassure the patient and try to keep them as calm as possible. The fact that their vision is impaired is going to increase their concern. If the patient has a cut near the eye, give them a tissue so they can wipe any blood that may trip down their face to make them feel a bit more comfortable. If you use an eye pad dressing, take care not to cover over the patient's ears. They will not be able to see and you need to make sure you don't also cover their ears and affect their hearing as well as their sight problem. When treating any eye injury it is important to remember that the eyes track together.

If you think the injury could be made worse by movement, you will need to cover both eyes. One example may be where there is a foreign object such as a piece of metal or wood in the eye, any form of eye movement will cause more damage. So in this instance, the patient should sit with their hands cupped over their eyes to protect them and stop them from moving their eyes. Keep your hand on their shoulder and talk to them so they know you are there while you wait for the emergency services to arrive. If you are moving a patient who has an eye injury, take particular care to keep them calm and reassure them. They are putting their total trust in you to guide them and take care of them. With eye injuries, you should not try and remove any object that has pierced the eye. Do not touch or rub the eye, do not wear make-up around the eye, and do not wear contact lenses until the eye is better.

The NHS guidelines for sending a patient to the hospital after an eye injury are when a strong chemical such as an oven cleaner or bleach is in the eye, a sharp object has pierced the eye, or something has hit the eye at high speed, for example, when using power tools or mowing the lawn, if there are any changes to the site in the eye after the injury, the patient has a headache, high temperature or sensitivity to light, they are feeling sick or being sick after the eye injury, they cannot move the eye or keep it open, and finally, blood or pus is coming from the eye.