Eye Injury

What is an eye injury?

Eye injuries include bruises, punctures, burns and scratches. They can result from traumatic accidents, exposure to chemicals or foreign objects in your eye. An eye injury can damage your eye, causing eye pain and vision loss, which may be temporary or permanent. Contact an eye care specialist right away if you have an eye injury. While some eye injuries can heal at home, others need urgent treatment.

What are the common types of eye injuries?

Common types of eye injuries include:

• Black eye: A blow to your eye and the tissues around it causes bruising, otherwise known as a black eye. A bruised eye usually refers to the tissues around your eye, rather than the eye itself. The area around your eye will be swollen and discolored like a bruise, in shades of black, blue or purple. Bruising can heal on its own, but a specialist can help rule out a more serious eye injury.
• Blunt eye trauma: Blunt trauma to your eye can fracture the bones around your eye (orbital fracture). A blowout fracture can cause the muscles that support your eye to be damaged or trapped between bone fragments. When blunt force directly contacts your eyeball, it can dislocate, detach, tear or break structures inside of your eye (globe contusion or globe rupture).
• Eye burns: Exposure to chemicals, radiation or extreme heat can burn the surface of your eye. A corneal flash burn is a minor thermal (heat) burn or sunburn on your eye due to sudden, intense exposure. UV (ultraviolet)radiation exposure can also cause more permanent damage to your eye over time. You can get a chemical burn from household cleaning products or other industrial chemicals.
• Eye scratches: A corneal abrasion is a scratch on your cornea, the clear dome on the surface of your eye in front of the iris. Makeup applicators, fingernails, cat claws, contact lenses or flying debris may scratch your cornea. Corneal abrasions cause pain, eye-watering and light sensitivity. Small scratches or pieces of grit in your eye may not be serious, but a deeper scratch may be.
• Foreign body injuries: A foreign body is a particle in your eye that doesn’t belong there. Sand, lawn clippings, metal shavings or shattered glass can fly into your eye. Foreign bodies irritate your eye and scratch it when it moves, and they can cause infections. If a foreign body is stuck in your eye and won’t flush out with tears, you might need a procedure to remove it.
• Penetrating injuries: A penetrating injury is when a sharp object punctures your eye, or when a high-speed projectile goes into your eye. Fishhooks, darts, sharp tools, BB guns and paintball guns can cause penetrating injuries. Penetrating objects might get stuck in your eye and need a specialist to remove them. They can cause bleeding and damage to the structures of your eye.

What’s the difference between an open globe eye injury and a closed globe eye injury?

Open globe injuries penetrate the wall of your eye, the white part (sclera) or the clear part (cornea). Your sclera protects the delicate inner parts of your eye. If blunt or sharp eye trauma injures these inner parts, it’s more likely to cause long-term damage and vision loss. A closed globe injury doesn’t penetrate the eye wall. Black eyes, blunt trauma and corneal scratches are examples of closed globe injuries.

What are the signs and symptoms of a potentially serious eye injury?

It can be hard to tell how serious your eye injury is based on how it looks or feels. You may not know if it’s penetrated the wall of your eye or not. Minor scratches or pieces of grit that get into your eye temporarily are less likely to be serious. But all eye injuries can be serious. When in doubt, it’s best to have a healthcare provider look at it. You can also look out for these warning signs and symptoms:

• Pain and swelling: If you have significant eye pain that doesn’t go away, it might be more serious. Notice if it has a stinging or burning quality, or if it hurts more in the light. Swelling is another sign that tissues have been damaged and they've begun the process of repair. You might have swelling around your eye or swelling of the white part of your eye.
• Eye bleeding: Bleeding (hemorrhage) can occur in different parts of your eye. A subconjunctival hemorrhage is bleeding on the surface of your eye, between your conjunctiva and sclera (the white part). Blood can also pool between your cornea and iris (the colored part). This is called a hyphema. Bleeding in the back of your eye (retinal hemorrhage) can affect your retina.
• Vision changes: If an injury affects your vision for more than a few minutes, take notice. You might begin seeing floating black spots or flashes of light, or a shadow covering parts of your vision. You might have blurry vision or double vision. Your child might not be able to tell you if they’re having trouble seeing, but you might notice them moving more slowly or awkwardly.
• Changes in eye appearance: Notice if the injured eye looks different from the other eye. One eye might look crossed or the pupil might look unusually large or small. One eye might seem to stick out of the socket a little or look more sunken in. The eyelid might twitch or droop abnormally. Or you might notice one eye seems to have trouble moving in a certain direction.
• Foreign bodies: If you know something went into your eye and it hasn’t come out, you’ll need a doctor to remove it. You might be able to see it in your eye. If it doesn’t come out with your tears, don’t try to remove it yourself. You might also think that you did remove the foreign object, but now it feels like it’s still in there. This is another sign that you need to see a doctor.
• Obvious eye trauma or deformity: If your eyeball is obviously wounded, or if any part of your eye or eye socket seems out of place or out of shape, don’t hesitate to seek care. Visible cuts, burns and leaking fluids from your eye are clear signs of injury. If you know that you have chemicals in your eye, you’ve had a serious injury. After flushing it with water, see a healthcare provider.

Why are eye injuries so painful?

Eye injuries are so painful because there are so many nerve endings in your eyeball. These nerves help maintain your eye’s protective reflexes, movements and visual processing. They also make your eye extremely sensitive to sensory input. Even a surface-layer eye injury, like a scratch on your cornea or conjunctiva, can be intensely painful because it exposes the nerve endings.

What are the common causes of eye injuries?

Common causes of eye injuries include:

• Sports injuries: Contact sports like football and boxing, sports involving flying balls and sports where you swing a racket, puck or bat are common causes of eye injuries. Many sports injuries are avoidable with the right protective eyewear. But not all sports have official protective gear.
• Workplace hazards: Industrial workers and tradespeople are often at risk of occupational hazards like flying debris, chemicals or radiation. Welding and metal work (grinding, hammering or cutting) are among the riskiest jobs. Construction, manufacturing and forestry are others.
• Household and yard work: Home improvement projects involving saws, drills, paints and other chemicals can lead to accidents and injuries. Lawnmowers and leaf blowers may blow debris into your eye. Cooking and cleaning may expose you to chemical or thermal burn injuries.
• Falls and collisions: Car accidents are a major cause of eye injuries, either from blunt impact or shattered glass hitting your eye. Falling into structures like doorknobs or furniture also causes eye injuries. Children might fall onto playground equipment or collide with each other.
• Toys and recreation: Flying toys, air guns and yo-yos are common causes of eye injuries in children. So are arts and crafts tools like crayons, pens and scissors. BB guns and paintball guns injure eyes of all ages. So do fireworks when untrained people use them in domestic settings.
• Violence: Domestic violence, assault and public brawls can lead to black eyes and other injuries. Riots and urban warfare may involve various weapons that can cause serious eye injuries. Explosives are another common cause of eye injuries in both military and urban combat.

How do eye specialists diagnose eye injuries?

Your provider will begin by asking about your symptoms and what happened when your eye was injured. If you’re in pain, they’ll do their best to relieve it before examining your eyes. They’ll look at your injured eye first, but they’ll examine both eyes to observe the differences. They’ll look for signs of eye trauma and then assess your vision. This might involve a variety of tests. Your provider might:

• Check your eyes and surrounding tissues for swelling, bruising, bleeding or wounds.
• Look for foreign objects or particles in your eye.
• Evaluate how your pupils contract (get bigger or smaller) and how your eyes move.
• Test your vision and use special equipment to look inside your eye during an eye exam.
• Order imaging studies like X-rays, ultrasounds, CT scans or MRIs of your eye and the area around it.
• Provide oral pain medications or put you under general anesthesia if necessary.

What can I do at home for an eye injury?

For chemical injuries, flush immediately with water for 15 minutes, then seek emergency care. For all other injuries, consult a specialist before you try to treat them at home. If it seems minor, you can try calling first to find out if you should come in for a visit. Once a specialist has evaluated your injury or treated it, they might decide you can take care of it at home. Home care for recovering eye injuries might include:

• Cold compress: Gently place an ice pack wrapped in cloth over your eye.
• Eye drops: Your provider might prescribe eye drops to help your eye heal.
• Pain relief: Your provider will tell you which pain medications are safe to use.
• Eye patch: Your provider might suggest covering your eye while it heals.

What can I do to prevent an eye injury?

Not all accidents are preventable, but many eye injuries are. The most important thing you can do to protect yourself from an eye injury is to wear the right protective eyewear for your activity. If you’re trying a new sport, home project or chemical product, carefully read the safety guidelines first. And always supervise children around sharp objects, projectile toys and household cleaning products.

What is the outlook for people with eye injuries?

The outlook for people with eye injuries varies. Early evaluation by an eye doctor and treatment can significantly improve the prognosis and help avoid permanent vision loss. The outlook depends on several factors, including:

• Amount of time before treatment.
• Severity of the injury.
• Type of eye injury.

When should I see my healthcare provider about an eye injury?

Call your provider right away if you or your child has signs of an eye injury. Untreated, many eye injuries can cause low vision, blindness and other eye problems.

If chemicals or other irritants are in the eye, flush the eye with clean water and call your provider. If a sharp object is stuck in the eye, don’t try to remove it. Seek care immediately.

If the injury is severe, call 911 or go to the emergency room immediately. Significant eye and vision loss associated with eye injuries can result in permanent vision loss if untreated.

A note from Cleveland Clinic

An eye injury can happen to anyone at any time, so be sure to take precautions and wear protective eye gear. If you or your child has an eye injury, don’t rub the eye. Never try to remove a sharp object from the eye or the area around the eye. Some eye injuries can cause permanent vision loss -- get medical care right away.