How to give first aid to eye trauma such as eye penetration

Penetrating eye injuries pose a great threat to vision, and the appropriateness of on-site first aid treatment is directly related to the recovery of patients' vision. Therefore, in the process of emergency treatment, the methods introduced below should be followed to try to buy more time for the patient.

1. Don't wipe your injured eyes at will.

When there is a penetrating injury to the eyeball, the injured person will feel a stream of hot tears (aqueous humor) gushing out of the eye at the moment of injury, and at the same time, there will be symptoms such as pain, inability to open the eyes, and vision loss. Wounds on the eyeball are often visible directly, and sometimes a black mass flows out of the wound (iris prolapse) or a clear, eggwhite-like colloidal substance (vitreous) emerges from the wound. The pupils are not round, and sometimes the pupils are not visible due to bleeding inside the eyeball.

If there is a large loss of the contents of the eyeball, the eyeball will soften or even collapse.

At this time, witnesses at the scene should not panic excessively, and at the same time comfort the patient to lie quietly immediately, avoid restless crying, do not wipe or clean the injured eye casually, and do not squeeze the injured eye to prevent more eye contents from being squeezed out.

2. Wrap it gently with a clean handkerchief.

The correct way to do this is to immediately loosen the wounded eye with a clean handkerchief or towel. It is important to note that both eyes must be bandaged together, because only in this way can the rotation of the injured eye due to contralateral eye movement be reduced, and the injured eye should not be aggravated by vibration, friction and squeezing, which may aggravate the wound bleeding and continue to drain the ocular contents.

Do not apply unclean eye drops when bandaging to avoid increasing the chance of infection. Do not apply eye ointment either, as it can make it difficult for the doctor to perform surgery to repair the wound; After the eyes are properly bandaged, the casualty should be carried to the hospital as soon as possible, minimizing vibration on the way.

Perforating the wall of the eye with a sharp object or a foreign object is called a penetrating injury. The most common injuries are knives, scissors, needles, glass, or foreign objects flying at high speed or piercing the eyes, with obvious pain and sharp loss of vision.

Common misconceptions: Returning the contents to the eye socket or rinsing with water. Both of these methods will only worsen the injury or cause infection.

Treatment: Once injured, do not try to remove the injury, do not wipe the blood scab on the wound, should be immediately gently bandaged with a clean dressing, sent to the hospital, and a professional doctor will perform different surgeries according to the injury**. If necessary, a cap of appropriate size can be used to disinfect it with boiling water, etc., cover the protruding injured eye, bandage it, and quickly send it to the hospital for emergency treatment.

At the same time, the casualty should avoid jolting and lowering the head as much as possible to prevent further prolapse of the eye contents.

1.Prevent infection.

Wipe the eyelids and their surroundings** first, and clean the eye area with a saline cotton swab but do not rinse. If contamination is suspected, wipe with 1 5000 litres of mercury solution or mercury oxycyanide solution. After various examinations and proper closure of the wound, antibiotics are injected subconjunctivally, antibiotic eye drops are placed into the conjunctival sac, and gauze is covered.

If the wound is large or deep, and the wound is exposed for a long time, intraocular antibiotics are injected, antibiotics are given in sufficient amounts throughout the body, and tetanus antitoxin or synoids are injected.

2.Seal the wound.

Properly treat the wound to prevent secondary infection and prolapse of the ocular contents, stop bleeding, restore intraocular pressure, and maintain the normal position of various tissue structures.

3.Prevent bleeding.

Bleeding prevention should be taken when the injury involves the uvea and retina. Bleeding can be treated with various hemostatic agents of Western medicine and Chinese medicine, the patient can lie still, hurt the eye or bandage both eyes, and deepen the eye shield to avoid vibration and compression of the eyeball. If there is heavy bleeding and slow absorption, vitrectomy may be done.

4.Prevents inflammatory responses.

For severe penetrating injuries, especially those with uveal injury, attention should be paid to preventing inflammatory reactions, and pupil dilation, topical and systemic corticosteroids, or non-steroidal hormone anti-inflammatory agents such as sodium salicylate, aspirin or indomethacin, as well as heat-clearing and wind-dispelling agents of traditional Chinese medicine, should be used.

5.Early vitrectomy.

For severe penetrating injuries, vitrectomy should be performed immediately if necessary while the wound is first treated and sealed. In the early stages of purulent endophthalmitis or panophthalmitis, vitrectomy combined with intraocular injection of antibiotics has a good ** effect.

6.Management of penetrating eye injuries.

Penetrating injuries to the eyeball, i.e., double perforation injuries or secondary perforation injuries to the eyeball. The posterior wound should be treated at the same time as the anterior wound. If the posterior wound is small, transvitreous diathermy can be performed to coagulate the retinal choroid around the wound if suturing is required.

If the posterior wound is large or has obvious retinal detachment, the scleral wound should be sutured, and transscleral diathermy or condensation or scleral pad pressure should be performed. Penetrating eye injuries should be performed early with vitrectomy.

7.**Treatment of injuries.

In addition to eye injuries, attention should be paid to the treatment of craniobrain, internal organs, and limb trauma, and lives should be saved first. **Most of the injuries are in both eyes, with multiple wounds, or multiple foreign bodies. ** Pay special attention to prevent infection.

According to the location and degree of injury, refer to the above methods for treatment.

8.Purulent endophthalmitis**.

Vitrectomy surgery should be performed as early as possible.

Fracture of the eyeball due to cuts or puncture wounds with sharp or pointed objects, foreign body debris entering the eyeball, and blunt force injury to the eyeball.

1.Vision: The degree of vision loss varies depending on the site of the piercing. If there is a simple perforation in the periphery of the cornea, the wound will be small and the vision may not be affected.

2.Anterior chamber: if perforated in the cornea or corneal sclera, the aqueous humor continues to overflow, and the anterior part becomes shallow, and if the wound is larger, the iris tissue can be protruded and incarcerated in the wound, and the pupil is deformed; If the sclera is perforated, the contents of the eye protrude into the wound, and the anterior chamber depth may remain unchanged or deepen.

The eyes should be contrasted and carefully distinguished.

3.Intraocular pressure: due to the perforation of the eyeball wall, the aqueous humor overflows rapidly, the contents of the eye are prolapsed, and the intraocular pressure is significantly reduced. Note that you need to be cautious when checking this intraocular pressure so as not to aggravate the prolapse of the ocular contents.