Magazine article Occupational Hazards

First Aid for Eye Injuries

Magazine article Occupational Hazards

First Aid for Eye Injuries

Article excerpt


Has one of your workers been hit in the eye and ended up with a shiner? The injury may appear superficial, but according to ophthalmologist and occupational health physician Bernard Blais, M.D., medical director of General Electric Corp., Schenectady, N.Y., even the most seemingly innocuous eye injury can harbor the potential for serious harm.

"You're better to err on the side of taking additional precautions than to take fewer precautions and risk more harm," explains Blais, who also serves as a member of the National Society to Prevent Blindness' national occupational eye health and safety committee.

Occupational Hazards contacted Blais for some "dos and don'ts" for first responders to keep in mind when a worker injures his eye. We started off with one of the most common types of eye injuries: specks or dust in the eye.

"The basic principle there is to not rub the eye," and to remove the speck as soon as possible, Blais says. "Sometimes, the patient can wash it out on site -- opening the eye and turning on the eyewash." An injured worker could also pull the upper lid over the lower lid, Blais adds.

"These techniques will frequently, right at the site of the injury, remove the foreign body," Blais says. But, if they don't work, the employee should be sent to the worksite clinic for medical attention. There, for example, medical personnel might evert the eyelid (turn it outward or inside out) and remove the foreign body with a moist cotton swab. If the company doesn't have a clinic, Blais adds, the worker should be sent to an ophthalmologist or to the closest emergency room.

Blows to the eye

For a blow to the eye, Blais recommends applying an ice cold compress for about 15 minutes to reduce pain and swelling. If the eye turns red, indicating some bleeding in the eyelid or on the eyeball, or if there is a decrease in vision, there could be internal damage. "It's not that the black eye, per se, is a very significant problem," Blais explains. "But, not uncommonly, a blow to the eye from whatever cause will lead to either a fracture of the skull around the eye, bleeding within the eye, or even rupture of the eye.

"If you've got a hemorrhage within the eye--a ruptured eyeball -- your vision will be markedly decreased immediately," Blais says, but he adds that problems don't always manifest themselves immediately. "An individual could get hit in the eye, get a black eye, have a little bit of bleeding within the eye which would not decrease his vision immediately, but which could bleed slowly and decrease his vision over time."

The best course of action, Blais explains, is to have the injured eye evaluated by an ophthalmologist. If the individual suffers an immediate decrease in vision, the preferred treatment, he says, is to call an ambulance to take the employee to the closest medical facility where an ophthalmologist is available.

As Blais notes: "The earlier you repair an injury to the eyeball, the better the prognosis."

Ruptures or cuts

If the eyeball has been ruptured or cut, "the last thing you want to do is squeeze the eyelid and/or put pressure on the eyeball," Blais says. He suggests covering the injured eye with an appropriate metal or plastic shield, or if one isn't available, placing a paper (or similar type) cup inverted over the eye, and taping it in place.

"Do not increase the pressure within the eye by means of squeezing or forcing the eyelid open to see what's going on and placing pressure mechanically with your hands on the eyeball," Blais stresses. Doing so, he says, is likely to aggravate a rupture or a hemorrhage in the eye.

If a worker's eye is ruptured or cut, Blais advises putting the injured person on a stretcher, covering both of his eyes with an appropriate protector, and getting him to the closest ophthalmologist for appropriate evaluation and treatment. …

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