Eye Injury

Overview

An eye injury is any harm to your eye or the skin and bone around it. It can be something small, like a scratch on the clear front surface (the cornea), or something bigger, like a blow to the eye, a splash of chemicals, or a sharp object going into the eye. Some eye injuries are painful right away. Others seem minor at first but need a doctor's check to make sure your sight stays safe.

Yes, eye injuries are common. They are one of the most frequent reasons people go to an emergency department or a walk-in clinic for eye problems. Most are minor scratches or small pieces of dust or grit, but some are more serious.

Anyone can injure an eye. Injuries are more likely in people who work with metal, wood, or chemicals, people doing DIY or gardening, people playing sports like squash, cricket, or football, and children playing with toys or sharp objects. Older adults may be more likely to injure an eye during a fall, and their eyes can be more fragile.

Symptoms

Common symptoms

• Pain or a sharp, stinging feeling in the eye
• Redness, watering, or a gritty feeling, like there is sand in the eye
• Feeling that something is stuck in the eye
• Blurred or hazy vision
• Sensitivity to light (light hurting your eyes)
• Swelling or bruising around the eye
• A red patch on the white of the eye (a small bleed under the surface)
• Being unable to open the eye comfortably

Symptoms in children

• Crying, clinginess, or being hard to settle
• Rubbing the eye again and again
• Keeping one eye shut or turning away from light
• Saying they cannot see well, or holding things closer than usual
• Not wanting to look at a screen, book, or toy they normally enjoy

Symptoms in older adults

• Injury may be harder to spot if eyesight is already reduced
• More bruising or swelling after a bump or fall
• Dry eyes can make scratches more likely and slower to heal
• A sudden change in vision may be caused by something other than the injury, so a check is important
• After a fall, an eye injury can come with other injuries that need checking too

Causes

Main causes

• Small objects getting into the eye — dust, sand, grit, insects, metal or wood fragments
• Chemical splashes from cleaning products, garden chemicals, or battery fluid
• A blow to the eye from a ball, fist, elbow, fall, or car airbag
• Sharp objects — fingernails, twigs, tools, pens — scratching or cutting the eye
• Bright light damage from welding arcs, strong sunlamps, or sunbeds
• Problems from contact lenses, such as a lens scratching the eye or an infection under the lens
• Foreign bodies like eyelashes or makeup irritating the surface of the eye

Risk factors

• Working with metal, wood, or chemicals without eye protection
• DIY, gardening, or mowing the lawn without goggles
• Playing racket sports, cricket, or other ball sports without protective eyewear
• Young children playing with toys that have sharp or small parts
• Wearing contact lenses, especially if you sleep in them or swim in them
• Dry eyes, which make the surface of the eye easier to scratch
• Previous eye surgery or eye conditions that make the eye more fragile
• Drinking alcohol, which raises the risk of falls and accidents
• Older age, where skin and eyes are more delicate and falls are more common

When to see a doctor

See a doctor urgently if:

• Any chemical splash in the eye, even if it feels better after rinsing
• Something stuck in the eye that will not wash out
• A cut, puncture, or object that went into the eye
• Sudden change in vision, or vision that stays blurry
• Severe pain, or pain that keeps getting worse
• A contact lens problem, or a lens you cannot remove
• A blow to the eye with swelling, bruising, or trouble seeing
• Blood in the eye, or one pupil looking different from the other

Book a routine appointment if:

• A mild gritty feeling that has lasted more than a day
• Redness or watering that is not settling after a day or two
• A small bruise or bump around the eye that is not painful and vision is normal
• Follow-up after an eye injury you have already had checked
• Questions about whether your eye protection is right for your job or sport

Diagnosis

A doctor or eye specialist will ask how the injury happened, when it happened, and what you were doing. They will check how well you can see, then look closely at your eye using a bright light and a magnifier. They may put a drop in your eye to numb it so the examination is comfortable, and a special orange dye to show up any scratches on the surface. The dye is harmless and washes away.

Tests that may be done

• A vision test — reading letters or shapes at a distance
• A careful look at the eye with a bright light and a magnifier
• Special dye and blue light to show scratches on the surface of the eye
• Numbing drops so the doctor can examine you without pain
• Checking the eye's pressure if there was a blow to the eye
• A scan such as an X-ray or CT scan if a piece of metal or glass may be inside the eye
• A check of the eye's acid or alkali level if a chemical splash was involved
• Referral to an eye specialist (ophthalmologist) for more detailed tests if needed

What to expect at your appointment

The check usually takes a few minutes and is not painful, though the bright light can feel uncomfortable. Your vision may be a little blurred for a short while after the numbing drops and dye, so it is best not to drive yourself home. You may be given advice, a follow-up appointment, or sent to an eye specialist the same day depending on what is found.

Treatment

Treatment depends on the type of injury. Many small scratches and bits of grit heal on their own with simple care. Chemical splashes need rinsing straight away — this is the single most important first-aid step. Serious injuries need to be seen and treated by an eye specialist. The aim is always to protect your sight and help the eye heal comfortably.

Self-care at home

• Rinse the eye with clean, lukewarm water if there is grit, dust, or a chemical in it — keep rinsing gently for at least 10 to 15 minutes for chemicals
• Do not rub the eye, even if it feels itchy or gritty
• Do not try to remove anything stuck in the eye yourself — leave that to a doctor
• Take out contact lenses if you have an injury, and do not put them back in until you are told it is safe
• Use a cool compress on the skin (not directly on the eye) for bruising or swelling
• Rest your eyes and avoid screens if they feel sore
• Wear sunglasses if light feels uncomfortable
• Avoid eye makeup and eye creams until the eye has healed
• Do not drive if your vision is blurry
• Attend any follow-up appointments so healing can be checked

Medical treatments

A doctor may remove a small object using special tools and numbing drops, which makes the process painless. Scratches are often left to heal on their own, sometimes with medicine to prevent infection, such as antibiotic eye drops or ointment. A protective contact lens or a soft pad may be used for some scratches. Burns and serious injuries are treated by an eye specialist, who may use specialised drops or other treatments. Always follow the instructions you are given, finish any course of medicine, and ask your pharmacist if you are unsure how to use eye drops.

When is surgery considered?

Surgery is needed only for more serious injuries. This might include a cut to the eye or eyelid that needs stitches, an object that cannot be removed without an operation, damage to the inside of the eye, or a build-up of pressure in the eye after a blow. An eye specialist will explain what is involved, the risks, and what to expect afterwards.

Living with this condition

Most people are back to normal within a few days to a couple of weeks, depending on the injury. While you heal, you may need to rest the eye, use drops as instructed, and avoid dusty or windy places. Some injuries mean a longer recovery and follow-up appointments, but the eye team will guide you through each step.

Lifestyle tips

• Avoid dusty, sandy, or smoky places while your eye heals
• Stay away from swimming pools and hot tubs for a while to lower the risk of infection
• Wear your glasses rather than contact lenses until you are told it is safe
• Wear eye protection when you return to work or sports, especially if the injury happened there
• Let your employer or coach know about the injury so they can help you stay safe
• Get plenty of rest — tired eyes feel more sore

Diet and exercise

You do not need a special diet for an eye injury, but eating and drinking normally helps your body heal. Drinking enough water helps keep your eyes comfortable. Gentle everyday activity is fine, but avoid heavy lifting, strenuous exercise, or contact sports until your eye has healed or your doctor says it is safe. If you have questions about your usual exercise routine, ask your healthcare team.

Mental health and emotional wellbeing

An eye injury can be frightening, and it is normal to feel anxious about your sight. For most people, that worry fades as the eye heals. If you feel low, panicky, or unable to stop thinking about your eye, tell your doctor — support is available and it helps. If you ever feel you cannot cope, contact your local emergency number or a crisis support line in your country right away.

Prevention

Many eye injuries can be prevented. The single best step is wearing the right eye protection for the job or sport, and taking a moment to think before you start.

Vaccines

There is no vaccine that prevents eye injuries. Staying up to date with your general health checks and vaccinations helps you recover from any injury or infection.

Screening programmes

There is no routine screening test for eye injuries because they happen by accident. That said, regular eye checks are worthwhile if you work in a high-risk job, have an existing eye condition, or wear contact lenses — they help catch problems early and keep your prescription up to date.

Complications

If left untreated

• Infection of the surface of the eye, which can be serious if it is not treated
• A sore or ulcer on the clear front of the eye
• Scarring that can blur or distort vision
• A build-up of pressure inside the eye after a blow
• Damage to the retina (the light-sensitive layer at the back of the eye)
• Long-term or permanent changes to your sight, in serious cases

Long-term outlook

The outlook is good for most eye injuries. Small scratches and bits of grit usually heal within a few days with no lasting effects, and even many more serious injuries can be treated well when they are seen quickly. Getting help early is the biggest factor in protecting your sight. If you are ever worried, it is always better to be checked.

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