Eyes are the least redundant thing you have. In a household doing its own woodwork, metalwork, chopping, lime work, bleach handling and fire tending, they are also unusually exposed.
Most of this page is about acting fast and then not making it worse.
Chemical splash, which is the true emergency
Why both eyes get covered
The instinct is to cover the injured eye and leave the good one working. For a penetrating or embedded injury, that is wrong.
The eyes move together. Whatever the uninjured eye tracks, the injured one follows, and that movement drags on a penetrating object or an open wound. Covering both stops the tracking and keeps the injured eye still.
It is disorienting and frightening for the person, so explain what you are doing, stay with them, keep talking, and lead them by the arm. Do not leave someone with both eyes covered on their own.
For a simple loose speck or a minor irritation, do not cover both eyes. It is a specific measure for serious injury, not a general rule.
A loose foreign body
Grit, an eyelash, sawdust, an insect. Uncomfortable, rarely serious.
- Do not rub. Rubbing drags the particle across the cornea and turns an irritation into a scratch.
- Blink several times, and let the eye water. Tears clear most things unaided.
- Pull the upper lid down over the lower lid and let go. The lower lashes often sweep the particle out from under the upper lid.
- Irrigate with clean water or sterile saline, from the inner corner outward.
- Look for it in good light, pulling the lower lid down and asking them to look up, then everting the upper lid if you know how.
- Lift it off with the corner of a clean damp cloth if it is visible and sitting loose on the white of the eye.
- Do not use tweezers, cotton buds or anything rigid near the eye.
If it does not come out, or the eye still feels gritty afterwards, there may be a corneal abrasion or something still lodged under the lid. Both need looking at. A scratched cornea heals in a day or two but is very painful and can become infected.
Embedded or penetrating
Blows to the eye
A punch, a ball, a branch, a fall.
- Cold compress over the closed lid, wrapped, for swelling. No pressure.
- Do not press on the eyeball itself.
- Check vision in that eye, covering the other, as soon as they can open it.
Seek urgent help for any of: double vision, loss or blurring of vision, floaters or flashing lights, a shadow or curtain across the vision, blood visible in the coloured part of the eye, a pupil that is not round or does not react, severe pain, or inability to move the eye normally.
A blow hard enough to break the bone around the eye can trap the muscles, which shows up as double vision on looking up. That needs assessment.
Flash burn and snow blindness
Ultraviolet burns to the surface of the eye, from arc welding without a mask, or from sun on snow or water.
The characteristic feature is the delay. Symptoms appear 6 to 12 hours after exposure, usually waking the person in the night with severe gritty pain, watering and light sensitivity. Because of the delay, people do not connect it with what they did that day.
Treatment: rest the eyes in a darkened room, cold compresses, paracetamol or ibuprofen, and do not rub. It usually settles in one to two days. Seek help if vision is affected or it is not improving.
Prevention is total: never look at welding without proper protection, even briefly, even from across a room, and wear sunglasses on snow.
Protecting eyes in the first place
The cheapest and most effective thing on this page.
- Safety glasses for everything: chopping wood, grinding, hammering metal, strimming, drilling, working overhead, handling bleach, lime, lye or fuel.
- A pair in every place work happens, not one pair in a drawer. Glasses you have to fetch are glasses you do not wear.
- Sunglasses on snow and water.
- Keep a spare pair of prescription glasses if anyone wears them, plus the prescription itself in the document pack. In a long emergency, a broken pair of glasses with no optician is a serious loss of capability.
- Sterile saline pods in the first aid kit for irrigation. Cheap, and far better than fumbling for a clean container.
- Know where the nearest running water is before starting any job involving chemicals.