Eye Injuries

WELCOME

Anatomy of the Eye:

Parts of the Eye:  Conjunctiva: Thin membrane covering the eye  Sclera: The whites of the eye  Cornea: The fixed focus lens  Aqueous Lens: The fluid that fills a small chamber behind the cornea  The Iris: The coloured part of the eye  The Pupil: The hole inside the iris ring

Parts of the Eye:  The Vitreous Humour: Thick jelly like fluid that fills the eyeball and keeps it firm  Retina: The curved back layer of the eye covered in light sensitive cells ( roots & cones) that can see shapes, colours & patterns  Optic Nerve: Sends info from the retina to the brain.

History: Casualty Sheet:  Mechanism of injury – How did it happen, safety glasses, time frame, welding?  Were they wearing contacts?  Was it a projectile object?  Was force involved?  Was the pt working with metal or in an environment where there may be metal debris?

Eye Injuries: oFlying Particles oForeign Bodies oWelding flashes oChemicals oSharp tools or objects oBlunt tools or objects

Foreign Body:  Depending on what it is and how the injury happened, a FB may pierce the eye and cause serious injury or may simply go away with nil long term problems. Symptoms Include: oSharp pain in your eye – followed by burning, irritation tearing and redness oFeeling that something is moving around the eye when it is closed oScratching sensation over your eye when blinking oBlurred vision or loss of vision in the affected eye oBleeding into the white part of the eye OR the coloured area – this indicates a significant injury. oCan’t stand the light

Foreign Body Eye: Examine the eye:  Ask the pt where they feel the irritation or scratching is?  Irrigate with normal saline  Invert the upper eyelid with cotton bud - How?  If visible with the naked eye – can remove with wet cotton bud-gently swipe.

Foreign Body: oRubbing may scratch or push the FB in further (Corneal abrasion) oEye wash in some cases may be enough oFB will often hide behind the upper eyelid oWill scratch if not removed oURGENT : Vision can be effected oNote with metal rings can occur if not removed

Foreign Body:

Rust Ring to Eye:

Treatment:  Eye wash  Look at the pupil – are they equal  Always ask pt if improvement post eye wash  Always ask the pt to return 2 hours post wash - either to you or Medical centre  A FB Especially metal can cause blindness if not treated (rust rings start within 3 hours)  Corneal Abrasions have good outcome (Heal in 48hrs) if treated early with AB eye ointment

Treatment:  Despite irrigating the eye. There may be FB that cannot be seen with the naked eye and needs to be examined closer – contact the OHN  OHN -If needed during working Hours an Ophthalmologist App can be organised.

Treatment:

Chemical Burns:  Wash immediately with copious amounts of water  Get MSDS  Treatment essential OHN  Usually treated 2-3L N/Saline.  Sent off for further treatment  Lead to infection, scarring, loss of sight

Penetrating Eye Injuries: oSharp or blunt injuries oMedical Emergency oPotentially cause blindness oPreventable oDo not use eye patch – If Necessary use a paper cup cut on angle (do not put any pressure on the eye) oDo not removed a penetrating object

Prolapsed Iris:

Conjunctivitis: oInfection Eye oGeneral Health Issue oWatery oRedness oItchy oIrritation oDischarge oTreatment – AB Ointment.

Lime Burns:

Flash Burns: oWelding without safety shield or standing close to someone welding oUsually occurs 6-12 hours after event oInflammation of the cornea (the clear tissue that covers the front of the eye) oLike sunburn in the eye oUsually heals in 1 – 2 days without leaving a scar oIf not treated can lead to infection

Symptoms: oPain mild or severe oBloodshot eyes oLight sensitivity oWatery eyes oBlurred vision oThe feeling of having something in your eye

Treatment:  Examination of the eye – stain eye  Phenylepherine drops ( FB must be excluded prior to use)  May require panadiene forte  Antibiotics  Review by ophthalmologist

If you have any questions, please ask your supervisor

Eye Injuries