Eye Injury, Blunt or Penetrating
Eye Injuries
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: dosing table
Adults
- Paracetamol, oral, 500 mg - 1 g 4–6 hourly when required (to a maximum of 4 g in 24 hours).
- Maximum dose: 15 mg/kg/dose.
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CAUTION - Review the problem daily. |
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.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_30 September 2024
Chapter 18: Eye Conditions_18.3 Eye Injuries_18.3.3 Eye Injury, Blunt or Penetrating