Eye Injuries (Ocular Trauma)

Chemical in the eye: first aid

Every second counts. Alkalis such as cement, lime (kapur), oven or drain cleaner and bleach can be even more damaging than acids [1][2].

1. Rinse

   Straight away, hold the eye open and pour clean running water (tap water or a shower is fine) over it, from the nose side outwards.

2. Keep going

   Rinse for at least 15 minutes. Remove contact lenses if they come out easily, but do not stop rinsing to do it.

3. Go

   Go to the Emergency Department straight away. Bring the product container or its name with you.

Also go straight to Emergency if, after any injury, you have:

• vision loss or blurred vision that does not clear
• a dark red pool of blood in the coloured part of the eye
• an eye that looks misshapen, or a pupil that is an odd shape
• double vision, or the eye cannot move normally
• a deep cut on the eyelid, or the injury came from a high-speed object such as hammering metal or a firework (mercun)

• Blunt injury: a punch, ball, elbow, fall, or a car airbag. This can cause bleeding inside the eye, a broken eye socket, damage to the retina, or high eye pressure [1][3].
• Sharp (penetrating) injury: glass, metal, a knife, a stick, a fish hook or a pencil. This can cut through the eye and needs emergency surgery.
• Chemical injury: cleaning products, bleach, cement, lime, fertilisers or car battery acid splashing into the eye.
• Something in the eye (foreign body): dust, sand, an insect or a small metal chip, especially when grinding or drilling.
• Scratch on the cornea (corneal abrasion): from a fingernail, branch, paper or makeup brush. Very painful but usually heals in a few days with treatment.
• Burns from light: looking at welding without a mask, or at the sun (including during an eclipse).

Do [1][2]:

• Rinse with plenty of clean water for chemicals or dust.
• For a sharp injury, gently cover the eye with a paper cup or rigid shield without pressing on it, and go to Emergency.
• For a blunt injury, a cold compress (ice wrapped in a cloth) can ease swelling. Do not press it hard on the eye.
• Try not to eat or drink before seeing the doctor if the eye might need surgery.

Do not:

• rub the eye
• try to pull out anything stuck in the eye
• press on an eye that may be cut
• put ointments, traditional remedies, breast milk or old eye drops in the eye
• try to neutralise a chemical with another chemical (just use water)

Treatment depends on the injury [1][2]:

1. Washing out the eye fully, and checking the pH (acid level) for chemical injuries.
2. Removing small particles from the surface of the eye.
3. Eye drops: antibiotics to prevent infection, drops to ease pain and inflammation, and drops to lower eye pressure if needed.
4. Surgery: to repair a cut or hole in the eye, remove an object from inside the eye, repair the eyelid, or fix a broken eye socket or detached retina.
5. A tetanus injection if needed, and follow-up visits.

Some eye injuries, even ones that seem small, can cause problems weeks or years later, such as glaucoma or retinal detachment. Keep all your follow-up appointments.

• Wear safety glasses for DIY, grinding, drilling, cutting grass and gardening.
• Wear a proper welding mask for welding.
• Wear eye protection for sports like badminton, squash and football.
• Fireworks (mercun): keep children well away, and never lean over or relight a firework that has not gone off [4].
• Store chemicals in their original containers, out of children's reach, and wear gloves and goggles when using strong cleaners.
• Always wear a seatbelt in the car.

Where to get help in Brunei

For any serious eye injury, go to the hospital Emergency Department. Call 991 if there are other serious injuries, such as a head injury. For a minor scratch or something in the eye that has been rinsed out but still feels uncomfortable, you can walk in to a Community Eye Clinic during clinic hours.