Eye Injury (ER)
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|Wednesday, April 15th, 2009||Emily Halevy | CWK Producer|
“Sometimes when you get hit in the eye, you can scratch your cornea or get what we call a corneal abrasion. That’s very painful and affects your vision and can cause serious visual problems if it’s very deep or doesn’t heal properly.”
– David Goo, M.D., emergency pediatrics, Children’s Healthcare of Atlanta
“His little cousin threw a book at him in his eye. He cried and went to sleep, and I didn’t know it was that serious until he woke up,” explains Patricia Livas, grandmother of Coryell Williams.
And that’s when she noticed her grandson’s eye was bloodshot. The worry is that Coryell may lose some of the vision in his left eye.
“How many fingers am I holding up?” Dr. David Goo quizzes Coryell. “Two,” he says.
He can see, but how well? Has his cornea been damaged? “Sometimes when you get hit in the eye, you can scratch your cornea or get what we call a corneal abrasion,” Goo explains, “that’s very painful and affects your vision and can cause serious visual problems if it’s very deep or doesn’t heal properly.”
A test is done using a black light and a special dye called fluorescein. “If there’s a cut to the eye or a scratch to the eye, that scratch will pick up the fluorescein and it’ll brightly mark the area that’s injured,” explains the doctor.
“Now I’m gonna put a little tiny drop of this in your eye,” Goo tells Coryell. “Now we’re gonna look in his eye and we’ll see if there’s any scratches to the cornea.”
“We don’t see any scratch to the cornea, so that means that the cornea’s okay and that’s the important part,” says Goo, but, “You can see here where there’s this white part that’s normal and then the area where the bloody vessels have broken, so he has what we call a subconjuctival hemorrhage.
Simply put, there are broken blood vessels in his eye. “Fortunately,” the doctor explains, “subconjuctival hemorrhages resolve without any treatment, there’s usually no complications, and usually the eye redness is gone within two to three weeks.”
What We Need To Know
Children may sometimes awaken with swollen or puffy eyes that itch and burn. These symptoms can be alarming, especially if the condition seems to appear for no reason. But as most parents quickly learn, several common infections and injuries – some minor and some more serious – can easily be responsible for such eye symptoms.
Many children may obtain injuries to their eyes playing with family or friends – they can get poked, something can fly into their eyes, they can get hit in the eye with something, etc. The Oregon Health & Science University cites these additional problems that may be associated with children’s red, itchy, swollen eyes:
- Allergic conjunctivitis – Children with allergies can develop this problem, which causes both eyes to be red and swollen, itching and tearing. Antihistamines or eye drops may be needed for treatment. Avoiding the allergen (perfume, pet dander, reaction from flea bite, etc.) is the key to long-term prevention.
- Styes – A stye or hordeolum produces a tender, red swollen area on your child’s eyelid. It may point inward, or it may be on the outside of the eyelid margin. Treatment consists of warm compresses and sometimes topical antibiotics.
- Computer strain – Children who spend countless hours staring at computer or television screens may develop red, watery and itchy eyes, a headache and problems with focusing. Alleviation from these symptoms usually consists of resting the eyes.
- Foreign body – Having a foreign object in the eye, such as a piece of sand, can cause pain and swelling, especially with blinking and tearing. Older children may complain that it feels like something is stuck in the eye. Washing the object out of the eye with lukewarm water is usually the only treatment necessary.
While most of the common eye infections previously mentioned will disappear within a week, it is important that your child visits a doctor to rule out any long-term or serious eye problems. The Nemours Foundation suggests the following strategies to prepare your child for his or her visit with the doctor:
- Explain the purpose of the visit – Use very non-threatening language to explain to your child that the doctor “needs to examine you in order to find out how to fix this and help you get well.”
- Tell your child what to expect – You may not know what to expect during the examination. When you call to make the appointment, you can ask to speak to the doctor or a nurse to find out, in a general way, what will take place during the office visit and exam. Then you can explain some of the procedures and their purpose in gentle language, appropriate to your child’s age level. Your child will feel more secure if he or she understands what is going to take place and why it is necessary.
- Involve your child in the process – If the situation is not an emergency, allow your child to contribute to a list of symptoms that you create for the doctor. Include all symptoms you have observed, no matter how unrelated they may seem to the problem at hand. Ask your child to think of questions that he or she would like to ask the doctor. Write them down and give them to the doctor, or, if your child is old enough, let him or her write down and ask the questions himself or herself.
While some eye injuries and infections cannot be prevented, it is still important that your child has his or her eyes examined on a regular basis. The American Academy of Ophthalmology recommends a first eye exam at 6 months of age, again at the age of 3 or 4, and then every one to two years thereafter. In addition, the American Academy of Pediatrics cautions you to call your pediatrician or eye doctor immediately if you notice any of the following warning signs of any eye problem in your child:
- Eyes flutter quickly from side to side or up and down
- Eyes are always watery
- Eyes are always sensitive to light
- Any change in the eyes from their usual appearance
- White, grayish-white or yellow-colored material appears in the pupil
- Redness in either eye that does not go away in several days
- Continued pus or crust in either eye
- Eyes look crossed, turn out or do not focus together
- Frequent rubbing of an eye
- Frequent squinting
- Frequent tilting (or turning) of the head
- Eyelid(s) that appear(s) to droop
- Eye(s) that appear(s) to bulge
- American Academy of Ophthalmology
- American Academy of Pediatrics
- American Optometric Association
- Nemours Foundation
- Oregon Health & Science University
- Wake Forest University