First Aid for Eye Injuries

As I'm sure you well know, even an eyelash in your eye can be very painful. So an eye injury such as a black eye, a foreign object in the eye, or a cut on the cornea is definitely cause for medical attention.

Try to get in to see your family physician if that's possible. Your own physician is always your best bet because he or she knows you and your family—your medical history and medical insurance information doesn't have to be repeated.

Of course, as we all know, accidental injuries don't always take place at convenient times. If you can't see your family doctor, try a 24 hour Medicenter (a facility staffed with physicians for walk-in medical care). As a last resort, go to the hospital. Emergency rooms usually mean a long wait, but they are still your best bet if something happens in the middle of the night. Trust your judgment: If you are feeling panicked, take the injured person to the emergency room. However, if the situation seems to be under control and you are relatively calm, the Medicenter will probably suffice. (Sometimes the reason to go to the Medicenter or the emergency ward is one of convenience. Go to the one that is closer to your house!)

The main point is that you should get help quickly! Whether you go to your private physician, a Medicenter, or an emergency room, do not wait when someone suffers an injury to the eye.

There's a Fly in My Eye!

Flecks of dirt, bugs, and eyelashes all irritate the eye. Of course, they usually feel much bigger than they are: one grain of sand can feel like a large stone. In addition to pain and irritation, a foreign object in the eye can also cause redness, a stinging sensation when the person blinks, and sudden light sensitivity.

Unfortunately, these symptoms can cause someone to panic. An injured person's first impulse is usually to rub the eye to try to get rid of the pain. But this can have the opposite effect. Rubbing the eye can dig the dirt in deeper, causing more damage and making it even harder to remove.

Follow these instructions to remove an object that you can see from another person's eye:

1. Flush the eye with cool, clean water. Use a pitcher, a glass, or an eye dropper if you're not near a sink. If the object is lying on the surface of the eyeball, the flushing action should remove the object.
2. If you can still see the object on the eye and it does not flush out with the water, gently cover BOTH eyes with gauze pads and seek help as fast as you can.

If you cannot see anything in the injured person's eye, an object might be stuck under the eyelid. Follow these steps to treat that type of eye injury:

1. Flush the eye with cool, clean water and see if that alleviates the pain.
2. If flushing the eye doesn't work, first wash your hands to prevent infection.

Before You Put the Band-Aid On

Why cover both eyes if only one eye is affected? Your eyes work in combination. Keeping both eyes “closed” helps prevent all eye movement. This helps prevent excess irritation and provides a soothing effect (sort of a mini-sleep tank). Also, covering both eyes minimizes damage just in case there's an embedded object in the other eye that you cannot see.

3. Place the injured person under a good light (or anchor a flashlight so that you can see into the eye and still use both hands).
4. Have the person look up, and then you gently pull down the lower lid. If you can see a particle on the inside of the lower lid or at the lower edge of the eyeball, either flush it out with an eyedropper or gently touch a wet Q-tip or a moistened gauze strip or handkerchief to the particle so it adheres to the cotton.
5. Remove the Q-tip and rinse the eye with cool water
6. If you can't see anything on the lower lid, check the upper one. Take another Q-tip and curl the lashes and upper lid over it. Be careful not to pull.
7. If you see an object on the upper lid or on the upper surface of the eyeball, try flushing it out with water while holding the curled Q-tip in place.
8. If that doesn't work, very gently touch the particle with a wet Q-tip to see if it will adhere to the cotton.
9. Release the upper lid and rinse the eye with cool water.

Eye Scream: Cuts & Scratches

Cuts to the eye are, well, obvious to the naked eye. A cut bleeds and causes distortion to the eyeball. But scratches are a different matter. They can be very subtle. A scratch might feel like a pebble (or more like a boulder to the person in question) that has gotten into the eye. It feels as if a foreign object has “flown in,” even though you can't see anything. The eye can become bloodshot, and you might have trouble seeing clearly. Your eye will also feel very, very irritated.

Think of any cut or scratch on the eye as serious, and treat it as a medical emergency. Call for help, and while you are driving the injured person to a doctor, keep him or her in a semi-reclining position. Place a pillow beneath the head, if necessary. Cover both eyes with sterile gauze pads held in place with long strips of adhesive tape (as shown in the following illustration).

The list of DOs was easy. But just as important is the list of DON'Ts you need to follow when treating cuts or scratches on the eyeball, the eyelids, or even the skin around the eyes.

• Don't exert pressure on the eye to stop bleeding. Although it may look bad, eye bleeding is rarely dangerous, and pressure will only cause more damage to the delicate eye area.
• Don't attempt to remove contact lenses even if they are causing the injured person excessive pain. This too will exert pressure on the eye, which in turn can cause more damage.
• Don't let the injured person rub his or her eye. It will cause more irritation.
• Don't flush the eye with water. Bleeding, especially with loss of vision, can mean damage to the eyeball, a condition that water can further irritate.

Contact Lens Problems

Many people wear contact lenses. A responsible ophthalmologist or optician will have you practice taking out and putting in your contact lenses when you first get them, and he or she will instruct you on the methods for keeping them sterile and clean.

Today, soft wear contacts are the most popular. They are flexible, easy to use, and unlikely to irritate the eye. (They also come in an array of fashion colors.) Hard lens contacts are more cumbersome, but they are more suitable for some eye conditions. And often, people who start with hard lenses tend to stay with them.

Choosing between hard and soft lenses is a matter of personal choice (like choosing between a stick shift and an automatic, a Mac and a PC, potato and potatoe). Regardless, most wearers become comfortable with the process of putting in and taking out within a few weeks. But contact lens accidents can still happen, no matter how long a person has worn them.

The most common problems that contact wearers face include:

• Hard lenses pop out. Surely you've seen people on their hands and knees searching the floor for a contact lens like it is the proverbial needle in a haystack. Missing lenses are hardly an emergency. However, it's always good to have an extra pair on hand when you're planning a trip.
• Wind, earth, and fire often irritate the eyes of contact wearers. So do mascara and other eye makeup. To prevent such irritations, you can keep the windows closed while driving in a car and wear non-prescription sunglasses for protection. You might also try using hypoallergenic cosmetics, going without mascara, and putting the contacts in after applying eyeliner and before applying mascara (if brush you must).

  If a speck of dirt does get in the eye, there's no need to panic. Simply take out the contact, rewash in sterile solution, and then replace it. You might want to add rewetting drops if your eye is red and irritated.

• Pollen causes allergies to act up, resulting in itchy, watery eyes. If allergies are a problem, some people might have to go without contacts during the pollen season, and wear eyeglasses instead. If you are an allergic person but insist on wearing your contacts, make sure you drive in an air-conditioned car to prevent pollen from blowing into an open window. And always carry an extra lens case with you in case the irritation gets to be too much. You can also carry eye drops with you to soothe irritation.
• A soft contact lens suddenly contracts, curling up into the top of the eye. This can be quite painful, but it is best not to panic. If possible, the wearer should gently move the upper lid over the contact, pushing the curled up lens to the side of the eye. With clean hands, he or she can then remove the lens. Always clean the contact before replacing it. To soothe red, irritated eyes (which result from all the poking and curling), place a few drops of eye drops or rewetting solution in your eyes and wait at least a half hour before replacing your lens.

First Things First

Here's a simple tip just in case a dot of mascara or a fleck of dirt gets into your eye and, consequently, on to your contact lens. Always keep an extra contact lens case in your pocketbook, your attaché case, or even your back pocket. Make sure it's in fresh solution so that if you must take out your lens, you'll have a place to put it that's sterile and clean.

• A contact gets stuck on the eye. Especially when a person first gets contacts, the contact will sometimes adhere tightly to the eye. First, gently try to move it to the corner of the eye (as described in the previous item). If that doesn't work, have a medical professional take it out. You don't want to damage the eye. If it's the middle of the night and you can't get your contact out, try taking a few deep breaths (panicking won't help) and add rewetting solution to your eye to lubricate it. Then try again. If you still can't get your contact out, wait another 15 minutes. If you still have no luck, you'll have to go to the emergency room or a 24-hour Medicenter. Do not go to sleep with your contacts in (unless they are made for extended wear). Not only can that damage the eye, it can cause infection!

  Ouch!

  Chlorine and salt water can irritate eyes and contact lenses. If you're going swimming, it's best to take out the lenses before you go into the water. You can also purchase swimming goggles that have prescription lenses, if necessary.

  Contact lens problems rarely call for emergency treatment. But, when combined with a black eye, a cut on the eye, or an embedded foreign object, they can signal danger. Follow the instructions for whichever specific eye emergency you're dealing with and keep contacts in place until help arrives.

  Chemicals Get in Your Eyes

  As discussed in First Aid for Burns, when a person comes into contact with certain chemicals, they can burn and cause damage to all areas of the body. Likewise, when some chemicals get in the eye, they can cause burns, terrible pain, and even blindness. Some of the chemicals that can burn the eye include:

  Acid	Enzyme products used for clogged drains
  Bleach	Bathroom and kitchen cleaners
  Ammonia	Furniture oils
  Hair dye	Alcohol

  When a person gets a chemical in his eye, it is an emergency that requires immediate first aid. Follow these steps to administer the appropriate first aid treatment:

  First Things First

  If you don't have water handy, you can also use cool milk.

  1. Tilt the injured person's head to the side toward the injured eye. (You don't want the chemicals to get in the good eye as well!)
  2. Gently open the damaged eye the best that you can with the fingers of one hand.
  3. With the other hand, pour cool water into the eye.
  4. Keep pouring water in the eye until help arrives. The more you flush the eye, the better the chances that the chemical will wash out and no permanent damage will be done.

  A Black Eye

  A black eye usually looks worse than it really is (emotional pain aside). Whether it's the result of a punch, walking into a wall, or extreme suction caused by tight goggles while swimming, a black eye needs medical attention. Sometimes there is bleeding that's not outwardly apparent. Likewise, the injury that caused the black eye may have also caused a contact lens to scratch the cornea. And if the black eye is accompanied by swelling, the swelling may affect a person's vision.

  Sometimes a blow to the eye will cause swelling without “attractively colored hues.” Treat swelling as you would discoloration. A bruise is a bruise is a bruise, whatever color it may be!

  The best first aid is to take the injured person to a medical professional and let him or her take a look at the eye. While you're waiting:

  1. Make sure the injured person is lying comfortably on his or her back.
  2. Have the injured person keep his or her eyes shut. If necessary, cover both eyes with a sterile gauze pad. (When it is dark, there is less eye movement.)
  3. Soak a washcloth, a gauze pad, or any available piece of cloth in cold water, and place the wet compress over the closed eyes to ease discomfort.

Excerpted from The Complete Idiot's Guide to First Aid Basics © 1996 by Stephen J. Rosenberg, M.D. and Karla Dougherty. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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