Eye Injuries in Children | Diagnosis & Treatments

How are eye injuries diagnosed?

Some eye injuries go undetected because no symptoms are present. When an eye injury is suspected, a physician should be consulted. A physician can usually locate foreign matter in the eye by examining it with a magnifying glass under good light. If no foreign matter is present, your child's eyes and surrounding area will be examined to determine the presence and possible seriousness of an injury. During the examination, anesthetic eye drops may be administered to lessen eye pain.

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 (CT) scans.

How are eye injuries treated?

Treatment depends on the type of eye injury:

  • Foreign matter: Foreign matter in the eye usually requires only simple treatment. Blinking often forces sand or dust out of the eye, but a moistened cotton swab can also be used for removal. If foreign matter is embedded in the eye, treatment should not be attempted at home. Your child should be taken to the emergency room. A physician may apply surface antibiotics once the object is removed.
  • Scratched cornea: A scratched cornea usually heals without complications, but pain relievers and surface antibiotics may be prescribed. The treatment of cuts varies according to the extent of the injury. A small cut usually doesn't need stitches, but a severe cut to the eyeball requires immediate treatment and usually requires surgery.
  • Chemical burns: Emergency action is required when your child's eye has come in contact with chemicals. The affected eye should be immediately flushed with running water, and you should take your child to an emergency room. To ease the pain, a physician may apply a surface anesthetic. If eye damage is severe, surgery may be necessary.
  • Eyelid lacerations: If the laceration is simple, as determined by your child's physician, the cut will be sutured or stitched. Local anesthetic drops may be placed in the eye prior to the suturing, and 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 eye movement.
  • 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's also 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 ophthalmologist 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.