For getting to know how to manage trauma and burns to the eyes in a pre hospital scenario, have a look on it !!

1. TRAUMA TO THE EYES
PRE-HOSPITAL EMERGENCY CARE
MOHAMMED AHMED
Bachelor’s in emergency and trauma
JAMIA HAMDARD UNIVERSITY –NEW DELHI

2. ANATOMY OF THE EYE

3. STRUCTURE OF THE EYE INCLUDE FOLLOWING
SCLERA
Tough fibrous coat that helps maintain the shape of the eye
CORNEA
Transparent anterior portion of the eye that overlies the iris and pupil
CONJUCTIVA
Membrane that covers the sclera and internal surface of eyelids
IRIS
Pigmented part of the eye that surrounds the pupil
PUPIL
Circular adjustable opening through which light passes to the lens
RETINA
Receives light impulses and converts them to nerve signals
OPTIC NERVE
Provides the sense of vision
LENS
A transparent structure that can alter its thickness to focus light on the
retina

4. CLASSIFICATION OF EYE INJURIES
LACERATION
Eyelids
globe
ASSESSMENT
MOI
pain ,swelling ,redness ,inflammation
may be visual loss
MANAGEMENT
1. Bleeding from eyelids due to laceration ,may be heavy ,but it
usually can be controlled by gentle manual pressure
2. Never exert pressure on or manipulate the injured globe in
any way.
3. If part of the globe is exposed ,gently apply a moist sterile
dressing to prevent drying
4. Apply soft sterile dressing to both eyes and provide prompt
transport to the hospital

5. EYE LACERATION

6. BLUNT EYE INJURIES
 Orbital blowout fracture
Assessment
- ecchymosis, swelling, pain
- double vision (diplopia)
- tenderness
Management
- suspect it is associated with facial fracture
- apply cervical collar
- manage airway in a standard fashion
- apply soft and sterile dressing to both eyes and
transport rapidly

7. BLUNT EYE INJURIES
DIPLOPIA

8. RETINAL DETACHMENT
 Often seen in sport injuries,especially boxing.
 This painless condition produces flashing light
,specks,or floaters in the field of vision and a cloud or
shade over the patient vision.
 Cover both the eye with sterile dressing and transport.
 if hyphema or rupture of globe is suspected :
- take spinal motion restriction
- elevate the head approximately 40 degree to
decrease intraocular pressure
- discourage the patient from performing the
activities that may increase IOP.(eg,coughing).

9. HYPHEMA

10. AVULSION OF GLOBE
 On rare occasions globe may be displaced
(avulsed) out of its socket
- do not attempt to manipulate or reposition it in
anyway !
- cover the protruding eye with a moist ,sterile
dressing and stabilize it along with uninjured eye to
prevent further injury due to sympathetic eye
movement
- place the patient in a supine position to prevent
further loss of fluid from the eye

11. AVULSION OF EYE BALL

12. FOREIGN BODIES AND IMPALED OBJECT
 Foreign objects produce severe irritation
 Conjuctiva becomes red and inflamed
 Eye begins to produce tears in attempt to flush out the
object
 Intense pain
 Don’t rub the eye
 Wash eye with clean water
 If foreign body is impaled in the globe , do not remove it
!
 Stabilize the object with bulky dressing ; place a cup or
other protective barrier over the object and secure it
 Cover the unaffected eye too

13. IMPALED OBJECT

14. BURNS OF THE EYE
 Chemical burns - usually caused by acid or alkali
solutions
 Thermal burns - mainly eyelids exposed and are
frequently burned
 Superficial burns – it can result from UV rays from
an arc welding unit,prolonged exposure to sunlamp
or reflected light from snow covered area (snow
blindness) .
- may not painful initially but may become so 3 to 5
hours later ,as the damaged cornea responds to the
injury
- severe conjuctivitis along with redness , swelling
and excessive tear production usually develops

15. BURNS OF THE EYE

16. MANAGEMENT
 Your role is to stop the burning process and prevent
the further damage
 Burns caused by UV rays are most effectively
treated by covering the eye with sterile moist pad
and an eye shield
 application of cool compresses lightly over the eye
may relief the pain
 Use snow goggles or other kinds of sunglasses
 For chemical burns – begin immediate irrigation
with sterile water or saline solution .
 Never use any chemical antidotes

17. SNOW GOGGLES

18. IRRIGATION TECHNIQUES
 Ideally you should use a bulb or irrigation syringe ,a
nasal cannula , or some other device that will allow you
to control the flow
 Always flush from the nose side of the eye towards the
outside to avoid flushing material into the other eye
 Irrigate the eye for at least 5 minutes . If the burn was
caused by an alkali or a strong acid , irrigate the eye
continuously for 20 minutes
 In some circumstances ,you may have to pour water into
the eye by the holding the patients head under a gently
running faucet.
 You can have the patient immerse his or her face in a
large pan or basin of water and rapidly blink the affected
eyelid
 Avoid contaminated water to getting into the unaffected
eye .

19. EYE IRRIGATION TECHNIQUE

20. EYE WASH STATION