First Aid for Eye Injuries

The eye is a delicate organ and can easily be damaged by careless handling or by using inappropriate medicines. Whenever possible, consult your eye surgeon. The first aid pointers below are for emergencies and when the services of an eye surgeon are not immediately available.

What is the method of removal of dust or foreign bodies from the eye?

Foreign bodies like dust, pieces of grit, or even wings of insects can suddenly get into the eye. Usually they enter without warning, and the sufferer only realises it when a sharp pain is’ felt, accompanied by profuse watering. Often the watering itself, washes the particle out of the eye.

The first step is to wash the eye with water. Splashing is usually of no use for the lid will close just before the water hits the eye. It is better to use an eye cup, failing which a regular tea-cup filled to the brim with water can be used. In an emergency, even a cupped hand sometimes works. The eye should be immersed in the water. Blink repeatedly and roll the eye around. In a few moments the particle is usually washed out.

If this procedure does not work, the next step is to take it out manually. The place where most particles are found is just under the upper lid, 2-3 mm from the lash-bearing area of the lid. There is a small shallow furrow here in which the offending particle will remain trapped.

There are two ways to remove the particle. The simplest way is to press the two lids together in a manner such that the upper lid rides over the lower lid. This method thus uses the lower lid to clean out the furrow on the inner surface of the upper lid.

The other way is to invert or (as doctors say, evert) the upper lid. To invert the lid, hold the lashes of the upper lid with your index finger and thumb. Place a smooth point like a ball pen with its tip retracted on the upper lid and roll the lid over it. Usually, the particle is clearly visible and can be removed using the tip of a handkerchief or a tissue.

Sometimes the particle is visible on the clear cornea of the eye. An easy way to remove it is first to dull the eye with a few drops of ice water. A good flash light (a battery torch) directed from the side is an excellent aid. The wet end of a clean handkerchief or a tissue can be used to sweep the foreign particle out. Never, never, lick the handkerchief to wet it before using, for the mouth harbours germs and may infect the eye. Clean drinking water is best.

If there is any difficulty it is best to visit your eye surgeon who can take a foreign body out, specially if it is deeply embedded, cleanly, with no damage to the eye.

How should one deal with irritant chemicals or oil in the eye?

Chemicals can accidentally enter the eye, the common chemicals being lime, acids, alkalies or burning oil. The treatment should be immediate. Splash water in large quantities in the eye. Do not try to “neutralise” an acid with an alkali or vice versa. The neutralization is accompanied by heat which is fatal to the eye. Water is best. A safe alternative, especially to lime and acid burns, is milk.

To soothe the eye after a burn, a little antibiotic ointment or even simple castor oil is usually adequate.

If the bums are due to an electrical flash or a fire, castor or olive oil is the best temporary palliative till the patient can be rushed to medical attention.

All burns are potentially dangerous and like the proverbial iceberg, often the damage visible is merely the tip. It is imperative that an eye doctor be contacted as soon as possible. After any burns there is usually a reaction followed by fibrous tissue formation which may lead to loss of effective vision.

How are eye drops put in the eye?

A fair number of people have extraordinary difficulty in putting in eye drops. The drops seem to splash here and there, the lids flicker up and down, but the drops will land everywhere but in the eye. There is nothing wrong it is merely an expression of the safety reflexes built in the eye to prevent damage to it.

Eye drops can be put in 3 ways

(A) The usual method is to hold the eye drop bottle with your thumb and middle finger with the index finger on the squeezable plastic portion.

The head is tilted back, the eyes look upwards. The little finger of the hand holding the eye-drop bottle takes support on the bone below the lower lid and simultaneously pulls the lower lid down. The index finger is now gently squeezed to permit the drops to fall in the eye.

To make it easier the other hand can hold the upper lid up.

The support method is the easiest way and ensures proper placement of drops.

(B) For little children, babies and finicky adults: It is a folly to try and force open the eye of a baby or a child to put in drops. Not only is it accompanied by a generous medley of sounds but also it does no good. The reflexes and the squeezing power in a child are so great that the lid will invert and close and squeeze the drop out.

The simplest way is to put the drops in while the child is sleeping. Place two drops in the corner of the closed lid. Usually putting the drops in will be enough to excite a reaction but you may clap your hands. Reflexly, the eyes will open and the drops will unobtrusively enter the eye.

Let the child go back to sleep before putting the drop in the other eye.

In adults, place the drops as mentioned, and open or roll the eyes. But immediately sit up and clean off the drop. This prevents it from trickling down via the tear sac to the back of the throat, which can cause a very irritative feeling in the throat and leave a nasty taste.

(C) The third way is the technique used when drops are to be put in by someone else. Let the patient lie down or sit with his head rolled back.

The patient is asked to look down, the upper lid is held back and the drop instilled. The advantage of this method is that the drops have a good “contact” time with the cornea, thus ensuring excellent absorption.

However, if the eye has been operated or injured in any way, the patient looks up, the lower lid is pulled down by pulling on the skin a centimetre away from the eye, and the drops are put in. This is to be certain that no pressure is exerted on the globe.

Since eye drops will automatically roll to the inner corner of the eye, first clear off the excess in the corner near the nose and then move the cotton outwards to mop up the excess drops.

Often patients ask how many drops should be put in the eye. Unless otherwise specifically indicated, 2 drops is the correct dose. Any excess drops will not be absorbed and will merely roll out of the eye.

How should eye drops be stored?

All eye drops should be stored away from any heat or light. Heat decomposes the drops, and will not only negate their action, but also, on the other hand, cause irritation. It is for this reason that no “old” eye drops should ever be used.

Perhaps the best place to keep eye drops is the butter compartment of your fridge (refrigerator). The butter compartment is usually built into the door with a folding or sliding door and does not get as cold as the rest of the fridge (thus keeping the butter soft).

An alternative is the last shelf of the fridge. Eye drops kept in the cold maintain their potency for fair intervals of time and have a longer “shelf” life.

If a fridge is not available any cool, dark corner of the house will do.

Unless it is important, try not to store eye drops. It is always better to buy a fresh bottle and discard it after its use is over.

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