Should Your Child See a Doctor?

Eye Injury

Definition

  • Injuries to the eye, eyelid, and area around the eye

Vision  

  • The main concern is whether the vision is damaged.
  • Older children can tell us if their vision is blurred or out of focus. Test them at home by covering each eye in turn and having them look at a distant object.
  • Children less than 5 years old usually need to be examined to rule out serious injuries affecting vision even if the injury seems minor.

When to Call Your Doctor for Eye Injury

Call Your Doctor Now (night or day) If

  • You think your child has a serious injury
  • Vision is blurred or lost in either eye
  • Child reports double vision or unable to look upward
  • Pupils unequal in size or abnormal shape
  • Bloody or cloudy fluid behind the cornea (clear part)
  • Object hit the eye at high speed (such as from a lawn mower, golf ball, fireworks)
  • Sharp object hit the eye (such as metallic chip)
  • Skin is split open or gaping and may need stitches
  • Any cut on the eyelid or eyeball
  • Constant tearing or blinking
  • Child keeps the eye covered or refuses to open it
  • Severe pain
  • Age under 1 year old
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Bruises near the eye (such as a black eye or bleeding into the white of the eyeball) in child less than 5 years old
 

Call Your Doctor During Weekday Office Hours If

  • No tetanus shot in over 5 years for DIRTY cuts (over 10 years for CLEAN cuts)
  • You have other questions or concerns
 

Parent Care at Home If

  • Minor eye injury and you don't think your child needs to be seen
 

Home Care Advice for Minor Eye Injuries

  1. Superficial Cuts or Scrapes:
    • Apply direct pressure for 10 minutes with a sterile gauze to stop any bleeding.
    • Wash the wound with soap and water for 5 minutes. (Protect the eye with a clean cloth.)
    • Apply antibiotic ointment such as Polysporin (no prescription needed) to cuts. Cover large scrapes with Band-Aid. Change daily.
     
  2. Swelling or Bruises with Intact Skin (including a Black Eye):
    • Initially, apply a cold pack or ice bag wrapped in a wet cloth to the area for 20 minutes per hour to reduce the bleeding. Repeat for 4 consecutive hours.
    • A black eye usually takes 1 to 2 days to develop.
    • A flame-shaped bruise of the white of the eyeball is also common. (called a subconjunctival hemorrhage)
    • After 48 hours, apply a warm wash cloth for 10 minutes 3 times per day to help reabsorb the blood.
     
  3. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as necessary for pain relief.
  4. Expected Course: Both of these injuries are harmless, last about 2 weeks and cannot be helped by any medicine.
  5. Call Your Doctor If:
    • Pain becomes severe
    • Changes in vision
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

References

  1. Brophy M, Sinclair S, Hostetler S, et. al. Pediatric eye injury--related hospitalizations in the United States. Pediatrics. 2006;117:e1263-e1271.
  2. Catalano RA. Eye injuries and prevention. Pediatr Clin North Am. 1993;40:827-840.
  3. Hertle RW and Bacal D. Traumatic hyphema: Evaluation and management. Contemp Pediatr. 1997;14(1):51-68.
  4. Hoffman RO. Evaluating and treating eye injuries. Contemp Pediatr. 1997;14 (14):74-98.
  5. Kundra M, Mahajan P. Subconjunctival hemorrhages in a teenage boy. Consult Pediatr. 2006;5(11):725-728.
  6. Rittichier KK, Roback MG, Bassett KE. Are signs and symptoms associated with persistent corneal abrasions in children? Arch Pediatr Adolesc Med. 2000;154:370-374.
  7. Tingley DH. Eye trauma: Corneal abrasions. Pediatr Rev. 1999;20:320-322.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/15/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.