EYE ACCIDENTS – FIRST AID GUIDE
This section is primarily intended to provide some general knowledge of eye emergencies, first aid, accidents, burns and eye scrapes. To do this, we will mainly focus on the symptomatology of the problems.
However, as most cases require the expertise of a professional, it is important to avoid making a diagnosis that can sometimes have serious consequences. It should be understood that most of the situations described have a myriad of symptoms that come together as a whole. Therefore, avoid oversimplification.
All eye injuries require first aid. Some may be commonplace, others will need to be promptly referred to a professional. A number of accidents can be seen and treated effectively in an optometrist's office.
Three types: thermal, chemical and radiation.
The eyes, in normal times, are protected by the eyelids and the blink reflex. Items that can cause burns may be soldering irons, curling irons, match heads (sulfur). Affected tissue will be burned first, second or third degree. The cornea, if it is affected, will have to be rid of the dead tissues in ophthalmology and treated with antibiotics. In first aid, cold water can be used for temporary relief. The use of fat on ocular surfaces should be avoided.
By far the most common, chemical burns represent a real eye emergency. Three types of products can be considered:
- petroleum products: gasoline, turpentine, benzine, aromatic products
- acids: including peroxide to sterilize contact lenses, car battery acids, vinegar, acids containing heavy metals
- alkalis: ammonia-based products (cleaners, refrigeration), lime, plaster, mortar, chlorine-containing products (swimming pool)
Care must be provided within seconds of the accident if maximum effect is to be obtained.
The story of the accident is important. When you are with the injured person, you should ask, if you do not already know, what type of household or chemical product has entered the eye and how much. Following this, it is necessary to carry out an abundant eye wash. Water can be used in the absence of physiological solution. Use the shower if necessary. A delay greater than 3 to 5 minutes or a wash of less than 20 or 30 minutes may darken the prognosis.
The beginning of the eye wash should be immediate. If delays occur during a possible transport to the hospital and / or waiting in an emergency room, these delays may be sufficient to lose the eye.
It is important to wash the eye immediately and, if the product that has entered the eye is unknown, call the Poison Control Center, the number of which should always be available for reference.
After 20 or 30 minutes of eye wash, patients should be seen by a professional. For mild burns (by ophthalmic peroxide for example), a mild antibiotic will often be sufficient.
Acid burns have a better prognosis than alkaline solutions. The acids often form precipitates, which stops their penetration. The alkalis penetrate deeply into the tissues and continue to cause tissue damage long after the accident.
Any burn with alkaline products should be referred to a corneal ophthalmologist, if available.
Following an alkaline burn, the eye may look very "white" rather than very red. This is due to ischemia or lack of blood circulation, the vessels have been obliterated by the chemical. In this case, the prognosis is very bad.
These burns are second in order of frequency. The most characteristic is the welder's flash. Burned workers are often the people circulating around a welder rather than the welder himself.
First aid may include eye wash with cold water. For added comfort, an occlusive dressing is used.
Keratitis by exposure to ultraviolet light
The cornea can be reached if too much exposure to ultraviolet light is obtained. Some situations may lend to this problem:
- cross-country skiing without protection during long hikes (keratitis of the skier)
- the beach at the edge of a watercourse
- solar beds without protection
Ultraviolet exposure causes mild keratitis that can be easily treated by an optometrist.
The most common cause of this type of accident is, as everyone knows, related to the altercations. Then comes the famous "black eye". It is important here to dispel some myths about the black eye. First, it is good to know that the bones forming what is known as the floor of the orbit, are very fragile, so a fracture is still to be feared. Bruising and blood effusions are more prominent in the lower eyelid.
If the vision is good and the eye moves well in all directions, we can conclude that the attack is minor. If not, the patient should consult. To detect a fracture of the floor of the orbit, one will palpate the eyelid. A crackling characteristic will be audible on palpation in case of fracture.
In mild cases, first aid treatment includes:
- alternate ice and hot water compresses
- start with cold towels for 24 hours to minimize swelling and decrease bleeding
- continue with hot pack applications
- an oral decongestant can be used
Lacerations affect the superficial layer of the cornea. They are often caused by foreign bodies that we will discuss later. Lacerations are also often caused by the edges of rigid contact lenses, by the nails of contact lens wearers, or sometimes by a tangential cut caused by a single sheet of paper. The degree of pain varies greatly between patients. If there is a tear, the person must consult as soon as possible.
The procedure includes the installation of a product to put the eye at rest and avoid complications, as well as an antibiotic and a compression bandage. The technique of the compressive dressing is simple and straightforward. Anyone initiated in first aid can easily master this technique.
This type of dressing is not indicated for penetrating wounds as well as injuries caused while wearing contact lenses.
The superficial cells of the cornea regenerate rapidly. A superficial injury is covered with new cells within 24 to 48 hours. However, the healing process involves the intake of deep cells and cellular regeneration lasts one week.
If the injury is deeper and reaches the basal cells of the cornea, the regeneration time of these cells is much longer and can reach 2 to 3 weeks. Since most wounds reach the superficial layers, it is good to wait a week before wearing contact lenses on an injured eye.
The greatest risk for an eye injury is a secondary infection that can sometimes be very serious.
Multiple situations arise where the patient has a foreign body problem in the eye. If the foreign body is released on the eye (for example, eyelashes), it can easily be dislodged with a cotton swab by the optometrist.
In many cases, metal particles are absorbed into the tissue and must be removed surgically and the person must be referred to an outpatient clinic.
First, you have to distinguish penetration and perforation. Penetration is when foreign bodies enter the superficial layer of the cornea during an accident. It is perforated when the foreign body crosses the whole thickness of the cornea.
These types of injuries are produced by scissors, pins, pencils, high-velocity projectiles, etc. In cases of penetration without perforation, there will be a treatment identical to cases of deep lacerations.
In the case of perforation, there will be blood in the anterior chamber of the eye. There will also be wrinkling of the iris and sometimes prolapse to try to plug the hole. If the piercing object is still located in the eye (eg: end of branch), do not try to remove it yourself, but cover the eye and take the person to the hospital emergency where an operation procedure will be undertaken as soon as possible.
The sequelae of such global penetration are difficult to assess, but may result in absolute secondary glaucoma and loss of the eye.
PREVENTION OF INDUSTRIAL AND DOMESTIC ACCIDENTS
The “Loi sur la santé et la sécurité du travail (Act respecting occupational health and safety) CNESST” requires the employer to provide a worker who occupies a risky occupation with all the appropriate protective equipment.
Safety glasses should also be available around the house for pruning or scrubbing and any unsafe do-it-yourself activities.
An excellent safety eyewear with polycarbonate lenses is available at a modest price. Since any accident has the potential to make you lose the use of your eyes, it is essential to apply as many preventive measures as possible.
A- A folded dressing is placed on the closed eye.
B- Two or three other compresses are used to protect the eye. The patient holds these compresses in place until a sheathed tape is applied.
A- Part of the ribbon is placed in the center of the compress and glued to the forehead.
B- The skin of the cheekbone is brought upwards before placing the bottom part of the ribbon. This will help keep the ribbon in place.