My Child Has...

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Some of the more recurrent injuries occur during the following activities:

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• Corneal Abrasions: A corneal abrasion is a scratch or injury to the cornea, the clear, dome-shaped surface that covers the front of the eye. This is a very common occurrence in children. There are many things that can cause an abrasion to the cornea. The more common causes include foreign bodies in the eye (such as dirt, pebbles, insects); a scratch from a toy or fingernail; contact lenses in older children. When these objects have contact with the surface of the eye, a small abrasion can occur.

• Chemical burns: These occur when a child gets any type of chemical in his/her eye. Chemical burns are a medical emergency, and the child should receive immediate medical care. Chemical burns can result in a loss of vision and even a loss of the eye itself, if not treated promptly and accurately. Household cleaning agents are a common cause of this type of injury.

• Hyphema: This refers to blood in the anterior chamber of the eye. The anterior chamber is the front section of the eye's interior where fluid flows in and out, providing nourishment to the eye and surrounding tissues. A hyphema is usually caused by a injury to the eye. Blood is seen in the eyeball. This is a medical emergency and immediate medical care is necessary.

• Bruising or Black Eye (Ecchymosis): Ecchymosis, or more commonly known as a "black eye," usually occurs from some type of injury to the eye, causing the tissue around the eye to become bruised. Your child's physician will examine the eye closely to make sure there is no damage to the actual eye itself.

• Fractures of the orbit: When one or more bones surrounding the eye are broken, the condition is called orbital fracture. The orbit is the bony structure around the eye. An orbital fracture usually occurs after some type of injury or a strike to the face. Depending on where the fracture is located, it can be associated with severe eye injury and damage.

• Eyelid lacerations: Eyelid lacerations are cuts to the eyelid caused by injury. Your child's physician will examine the eye closely to make sure there is no damage to the eye itself. An ophthalmologist (physician who specializes in comprehensive eye care) may also examine your child for further evaluation of the eye.

• Foreign bodies: Foreign bodies refer to any objects that are in the eye that are not meant to be there. The foreign object may be in the conjunctiva (a thin membrane that covers the actual eye) or in the cornea (the clear, dome-shaped surface that covers the front of the eye).

To help locate scratches and other small injuries, the eye is stained with an orange dye called fluorescein. This dye appears bright yellow under a blue examining light; with it, highlighted scratches and scrapes on the eye can be detected.

More serious eye injuries may involve imaging studies such as x-ray or computerized tomography scans. For more information on how eye injuries are diagnosed, link to specific injury listed above under "What are the Symptoms of Eye Injuries."

Scratched cornea
A scratched cornea usually heals without complications. Pain relievers and surface antiobiotics may be prescribed. The treatment of cuts vary according to the extent of the injury. A small cut usually does not need stitches, but a severe cut to the eyeball requires immediate treatment and usually requires surgery. See corneal abrasions.

Chemical burns
Emergency action is required when a child's eye has come in contact with chemicals. The affected eye should be immediately flushed with running water, and the child should be taken to an emergency room. To ease the pain, a physician may apply a surface anesthetic. If eye damage is severe, surgery may be necessary. See chemical burns.

Eyelid lacerations
If the laceration is simple, as determined by your child's physician, the cut will be sutured (stitched). Local anesthetic drops may be placed in the eye prior to the suturing. The sutures will usually be taken out five to seven days after the injury. Sedation or general anesthesia may be needed for younger, uncooperative children. For larger lacerations, or if there is any involvement of the eye, an ophthalmologist may be consulted to evaluate and treat the wound.

Hyphema (blood in the eye)
Most children with hyphema should be treated in an emergency room. Treatment includes eye drops, a patch over the eye, and avoiding activities like reading to prevent movements of the eye. See hyphema.

Ecchymosis (bruised or black eye)
Most black eyes heal completely and do not cause any damage to the eye. Treatment may include cold compresses to the eye for the first 24 hours, followed by warm compresses to the eye until the swelling stops. The child's head should be elevated to help decrease the amount of swelling. It is important to know that the swelling and bruise may appear to spread and go down the cheek or to the other eye. This is normal. Consult your child's physician if the bruising and swelling does not resolve on its own.

Fractures of the orbit
Your child should consult with an opthalmologist to decide on treatment. In some cases, treatment may be delayed to allow for the swelling and bruising to go down. Double vision should resolve without treatment within three to four days. In severe fractures, or if the eye is involved, surgery may be needed. See fractures of the orbit.