Eye Injury

Pediatric HouseCalls Online

DEFINITION

• Injuries to the eye, eyelid, and area around the eye.

Vision

• The main concern is whether the vision is damaged.
• Older children can tell us if their vision is blurred or out of focus. Test them at home by covering each eye in turn and having them look at a distant object.
• Children less than 5 years old usually need to be examined to rule out serious injuries affecting vision even if the injury seems minor.

See More Appropriate Topic (instead of this one) If

• Foreign body present, see EYE, FOREIGN BODY 

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• You think your child has a serious injury.
• Vision is blurred or lost in either eye.
• Child reports double vision or unable to look upward.
• Pupils unequal in size or abnormal shape.
• Bloody or cloudy fluid behind the cornea (clear part).
• Object hit the eye at high speed (such as from a lawn mower).
• Sharp object hit the eye (such as metallic chip).
• Skin is split open or gaping and may need stitches.
• Any cut on the eyelid or eyeball.
• Constant tearing or blinking.
• Child keeps the eye covered or refuses to open it.
• Severe pain.
• Age under 1 year old.

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen.
• Bruises near the eye (such as a black eye or bleeding into the white of the eyeball) in child less than 5 years old.

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns.

Parent Care at Home If

• Minor eye injury and you don't think your child needs to be seen.

HOME CARE ADVICE FOR MINOR EYE INJURIES

1. Superficial Cuts or Scrapes:
   • Apply direct pressure for 10 minutes with a sterile gauze to stop any bleeding.
   • Wash the wound with soap and water for 5 minutes. (Protect the eye with a clean cloth.)
   • Apply antibiotic ointment to cuts. Cover large scrapes with Band-Aid. Change daily.
2. Swelling or Bruises with Intact Skin (including a Black Eye):
   • Initially, apply a cold pack or ice bag wrapped in a wet cloth to the area for 20 minutes per hour to reduce the bleeding. Repeat for 4 consecutive hours.
   • A black eye usually takes 1 to 2 days to develop.
   • A flame-shaped bruise of the white of the eyeball is also common. (called subconjunctival hemorrhage)
   • After 48 hours, apply a warm wash cloth for 10 minutes 3 times per day to help reabsorb the blood.
3. Pain Medicine: Give acetaminophen (e.g. Tylenol) or ibuprofen as necessary for pain relief.
4. Expected Course: Both of these injuries are harmless, last about 2 weeks and cannot be helped by any medicine.
5. Call Your Doctor If:
   • Pain becomes severe
   • Changes in vision
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.