this is the topic of b.bsc third yr, and gnm which include all the common eye injuries, its causes and management and nursing care

1. Eye Injuries
DEPARTMENT
OF
MEDICAL SURGICAL NURSING

2. Learning Objectives
At the end of this lecture the students will be able to:
• Landmarks of the eye
• Different types of eye injuries
• Emergency care for eye injuries
• Contact lenses, and how to remove them
• Dental trauma
• Emergency care for dental injuries

3. Eye Injuries
• The globe of the eye, or eyeball is a
sphere approximately 1” in diameter
• 5 most important landmarks of the eye:
– Sclera – the “white” of the eye
– Cornea – clear, front portion of the eye
which covers the pupil.
– Pupil – opening in which light enters
– Iris – colored portion of the eye
– Retina – back of the eye

4. Common causes of eye trauma:
• Blunt/penetrating trauma
• – Sport/recreational activities
• – Assaults
• – Chemical exposures from household products
• – Industrial accidents
• – Foreign bodies
• – Animal bites/scratches

5. TYPES OF EYE INJURIES
• Eye injuries are usually not life-threatening
• Time is of the essence in your treatment,
• – to help prevent any visual disturbances and
disruption
• 6 different types of eye injuries:
• – Foreign object in the eye
• –

6. • Injury to the orbits
• – Lid injury
• – Injury to the globe
• – Chemical burn to the eye
• – Impaled object/ Extruded eyeball

7. Foreign Object in the Eye
• Dust, dirt, sand, or fine pieces of metal can be blown
or driven into the eye and lodged there
• A flow of tears washes out many of these substances
before any harm is done
• A patient with a foreign object in the eye, will
complain of feeling the object, and the globe will
appear red

8. Emergency Care for a Foreign
Object in the Eye
• Flush the eye for at least 20 minutes
• If you cannot flush the eye, and the object is from the
white of the eye, try to remove the object
• Ask the patient if they have made any attempt in
removing the object – possibly causing an abrasion to
the cornea

9. • To remove the object:
• Pull down the lower lid while the patient
looks up, or pull up
the upper lid while the patient
• looks down, remove object with sterile gauze
• If unable to remove, cover both
eyes with bandages

12. Injury to the Orbits
Trauma to the face may
result in the fracture of one
or several bones that form
the orbits of the eyes
• Injuries serious enough to
cause orbital fractures, may
also cause a cervical
spine injury

13. Lid Injury
• Lid injuries include bruising,
burns, and lacerations
• Lid injuries can cause
profuse bleeding
• Anything that lacerates the
lid, can also cause damage to
the eyeball

14. Emergency Care for a Lid Injury
• Control bleeding with light pressure
• Do not use pressure if the eyeball itself may be
injured
• Cover lid with sterile gauze soaked in saline to
keep wound from drying
• Preserve any avulsed skin, and transport it with
the patient for later grafting
• If eyeball injury is not suspected, cover injured
lid with a cold pack to reduce swelling
• Cover both eye’s to decrease movement

15. Injury to the Globe
• Injuries to the globe include bruising,
lacerations, foreign objects, and abrasions
• Globe injuries should be treated with great
caution!
• Emergency Care:
– Apply patches to both eye’s
– Do not apply pressure if you suspect a ruptured
eyeball
– Pressure can force the eye contents to leak out

16. Chemical Burn
• Chemical burns to the eye represents a DIRE
emergency
• Permanent damage can occur within seconds
• The first 10 minutes following an injury often
determines the final outcome
• REMEMBER:
• Burning and tissue damage will continue to occur as
long as any substance is left in the eye…
even if that substance is diluted

17. Chemical Burn
Signs and Symptoms:
– Irritated, swollen eyelids
– Redness of the eye
– Blurred/diminished vision
– Excruciating pain in the
eye’s
– Irritated, burned skin
around the eye’s

18. Emergency Care for a Chemical
Burn
• Immediately begin irrigation with water or saline
– It need not be sterile, but should be clean
• Hold eyelids open so all chemicals can be washed
from behind the lids
• Continuously irrigate for a Minimum 20 minutes
• Remove contact lenses – may trap chemicals
• Remove any solid particles from the surface of the eye
Wash your hand’s afterward…Prevent contamination to
yourself!

19. Irrigation of a Chemical Burn

20. Impaled Object & Extruded
Eyeball
• Impaled or embedded
objects in the eye should
not be removed
• Your job consists of
stabilizing the object to
prevent accidental
movement or removal
• NEVER attempt to
replace the eye in the
socket!!

21. Impaled Object & Extruded Eyeball
Emergency Care
• Immobilize the head and spine
• Encircle the eye and impaled object/extruded eyeball
with a gauze dressing
• Do Not apply pressure!
• Stabilize embedded object with a cup or dressings
– Impaled object/extruded eyeball should not touch the
sides, or the top of the cup
* Make sure to bandage both eyes to prevent
movement

22. Stabilizing an Impaled Object &
Extruded Eyeball

23. Contact Lenses
• Eye injuries are often complicated by the presence of contact
lenses
• To detect lenses, shine a pen light into the eye
– A soft lens will show up as a shadow on the outer portion of
the eye
– A hard lens will show up as a shadow over the colored portion
of the eye (iris)
• Some patient’s only wear contact lenses in one eye, so make
sure to check both eyes
• Some patient’s wear both contact lenses and eye glasses
(elderly)
• You should remove contact lenses if there is a chemical burn to
the eye
• Do Not remove contact lenses if the eyeball is injured

24. Soft Contact Lenses
• Soft contact lenses are designed for extended wear,
but can cause damage if left in for a long time
• Over time, they can gradually dehydrate and shrink,
making removal difficult

25. You can remove Soft
contact lenses
with the following
method:
– Middle finger tip on
lower lid – pull lid
down
– Place index finger tip on
lower edge of
lens – slide lens down

26. • – Compress lens between your thumb and
• index finger – allowing air to get
• underneath it and remove it from the
• eye
• – If lens is dehydrated on the eye, run
• sterile saline across the eye surface –
• pinch it up to remove it

27. Summary
• So far we have discussed about definition, types,
emergency care. Dental trauma, how to remove
contact lens in eye injuries

28. Bibliography
• Lewis et al, Medical Surgical Nursing, Mosby
Elsevier,7th edition.
• Joyce.M.Black et al, Medical Surgical Nursing,
Saunders publication.
• Brunner and Siddhartha, Medical Surgical
Nursing, Lippincott Williams and Wilkins.

29. Thank You