What to Do for Blunt Eye Trauma

Taking an unexpected hit to your eye can be frightening, especially if you think it’s serious. Blunt eye trauma is one of the leading causes of blindness worldwide.

Without immediate treatment, injuries to your eye may even cause permanent damage. Here's your quick guide to recognizing danger signs, understanding what's happening inside your eye, and taking the right steps to protect your vision immediately.

What to Do After a Blunt Eye Injury

Blunt eye trauma should be evaluated by an eye-care professional as soon as possible, ideally the same day. This is because certain complications (such as a retrobulbar hematoma) can endanger vision within a few hours.

Here's what you should do if you've suffered blunt eye trauma:

• Get medical help immediately. If possible, call 911 for emergency services.
• Avoid touching your eyes until after you receive treatment.
• If bleeding, apply gentle pressure around the eye with clean cloths or gauze pads.
• Don't attempt to remove your contact lenses if you're wearing them.

What Are the Symptoms of Blunt Eye Trauma?

Symptoms of blunt eye trauma depend on the severity of the injury. Common mild symptoms include:

• Minor pain
• Bruising
• Swelling
• A black eye
• Trace amounts of blood over the white part (sclera) of the eye
• Eye tissue swelling or the buildup of fluid around the eye

How to Know if an Eye Injury is Serious

While an injury to the eye requires medical attention, most hits look worse than they are. However, some symptoms indicate a more serious injury, for example:

• Severe or worsening pain. Mild discomfort is common, but escalating pain can mean internal injury.
• Sudden vision loss or double vision. Blurry vision might clear, but significant changes, afterimages, or seeing double, mean potential serious damage.
• Flashes or floating spots in your vision. Bright flashes or many new floaters can indicate a retinal tear or detachment.
• Blood in the front part of your eye (hyphema). Visible blood pooling behind the clear front window (cornea) is serious.
• Irregular or "teardrop" pupil. If your pupil is oddly shaped or pointing to one side, it can indicate a ruptured eyeball.
• Pain or difficulty while moving the eye. This may indicate damage to the eye’s structure, muscles, or nerves. 

If you experience any of these, gently shield your eye without pressing on it, keep your head elevated, and head straight to the emergency department. Don’t wait or try home treatments—early medical attention is crucial.

What Happens When Your Eye Gets Injured?

When your eye gets injured, the structures within may also get damaged without breaking the surface. Depending on what’s affected, you may experience different symptoms.

Here's a quick guide on how these structures get affected:

• Cornea. Your eye’s clear, protective front "window" can suffer scratches or bruising, causing redness, pain, and sensitivity to light.
• Iris and lens. Behind the cornea, forceful impacts can cause internal bleeding (hyphema) or dislodge the lens, leading to blurry or double vision.
• Retina. The sensitive layer at the back of your eye (like the film in a camera) can be bruised or torn, leading to floaters or vision loss even days after the injury.

What are the Potential Complications of Blunt Eye Trauma?

Blunt eye trauma can lead to various complications, including:

• Globe rupture (bursting of the outer membrane of the eye)
• Retrobulbar hematoma (bleeding in the soft tissue behind the eyeball)
• Retinal detachment
• Orbital fracture (broken bones of the eye socket)
• Hyphema or bleeding in front of the eye
• Muscle entrapment following an orbital blow-out fracture
• Traumatic glaucoma
• Corneal abrasions (cuts on the clear, protective window at the front of the eye)
• Vitreous hemorrhage (bleeding into the jelly-like filling of the back part of the eye)
• Cataracts

Blunt trauma can lead to vision loss. Therefore, any trauma to the eye should be considered an emergency.

How is Blunt Eye Trauma Treated?

Treatment of blunt trauma depends entirely on the extent of the injury. Minor eye injuries can heal within 1 to 3 days, but more severe eye injuries can take several weeks or months to heal.

Treatment for mild blunt eye trauma often includes ice packs, pain relief medicine, and ample rest. However, more severe cases may require the following:

• Steroid eye drops to reduce inflammation
• Glaucoma eye drops to reduce intraocular pressure
• Antiemetics or anti-nausea medication
• Antibiotic ointment
• Wearing protective eyewear until the eye is healed
• Surgery
• Follow-up eye examinations
• Bed rest

Immediate At-Home Care

Sometimes you can’t get immediate care. Fortunately, there are some simple steps you can take to reduce swelling, ease discomfort, and protect your vision while waiting for professional care.

These include:

• Apply a cold compress to your eye for 10 to 15 minutes at a time, about once each hour during the first day.
• Keep your head elevated to help drain fluid from your eye and reduce swelling.
• Use a rigid eye shield to prevent further damage or prevent yourself from touching your eye accidentally.

You can also use over-the-counter medication for pain relief, but stick to acetaminophen (Tylenol). Aspirin, ibuprofen, and NSAIDs can increase your risk of bleeding.

How to Avoid Blunt Eye Trauma 

To avoid future incidents of blunt eye trauma, you should take these steps:

• Always wear protective eyewear when participating in sports activities.
• Never drive while intoxicated.
• Store chemicals safely and always handle them properly.
• Be careful when handling fireworks, firearms, knives, and other sharp objects.
• Wear your seatbelt when you’re in a car, whether you’re the driver or a passenger.

Find an Eye Doctor

Don’t leave your vision to chance—professional evaluation after any significant eye trauma can make all the difference. Find an eye doctor near you through VisionCenter or visit the American Academy of Ophthalmology for trusted resources and expert guidance.