Duration Health — Field Guide: Eye

Eye

Introduction

Trauma to the eye can cause multiple problems, including a scratch or abrasion to the outer layer of the eye, the cornea (corneal abrasion), which can cause pain, tearing, light sensitivity, or a grainy feeling on the eye, and the eye may look bloodshot. Eye trauma can also cause the retina to become detached from the back of the eye (retinal detachment), causing vision changes including seeing flashing lights and floating spots. If trauma to the eye is severe it can rupture the eye (globe rupture), which is a medical emergency and can lead to loss of the eye. If the eye is red, itchy or painful and no injury is suspected, an infection might be the cause. Most eye infections are viral (viral conjunctivitis) and go away on their own. If the infection isn't going away, or there is a significant amount of drainage, it may be due to a bacterial infection (bacterial conjunctivitis), and antibiotic eye drops can be used. Snow blindness is another affliction of the eye, when extreme UV radiation causes a “sunburn” to the eye. This is more common at higher elevations when the powerful light reflects off snow. It is important to wear proper sunglasses to prevent snow blindness.

Treatment

If a corneal abrasion is present, antibiotic eye drops called ofloxacin can be used to treat it and prevent infection. If a bacterial infection of the eye (bacterial conjunctivitis) is suspected, these same ofloxacin drops will treat the infection and help resolve symptoms. Retinal detachment requires surgery, so you should seek immediate medical care. Tetracaine and proparacaine are anesthetic medicines used to numb the eye for short-term symptomatic relief after an injury, or to numb the eye to allow for irrigation (washing out) or removal of a foreign body. Do not attempt to remove large foreign bodies that have perforated the eyeball – you must cover the eye to protect it from further damage and evacuate the patient immediately for medical treatment.

When To Worry

Seek immediate medical care if you have any of the following:

  • foreign body perforates/penetrates the eyeball
  • loss or deterioration of vision
  • any eye symptoms that do not improve in 1-2 days
  • pain, redness or swelling worsens
  • you see floaters or flashes in your field of vision
  • eye pain is severe and accompanied by fevers or persistent vomiting
  • protrusion/bulging of the eyeball
  • change in shape of the pupil

Pediatrics

Quick Guide

If you have

  • eye irritation, redness, tearing in BOTH eyes
  • runny nose
  • possible exposure to allergen
  • known history of seasonal allergies

You may have

allergic rhinitis (seasonal allergies or "hay fever")

Consider using

ketotifen (generic for Zaditor®) 1 drop in the affected eye(s) every 12 hours as needed

See also: Nose and Sinus

If you have

  • minor trauma to the eye
  • eye pain, redness, tearing in ONE eye
  • light sensitivity
  • a grainy feeling on the eye

You may have

corneal abrasion

Consider using

ofloxacin 1 drop in the affected eye 4 times per day for 7 days

OR

erythromycin half inch of ointment in the affected eye every 6 hours for 7 days

and seek emergency medical care

If you have

  • eye pain and redness in ONE or BOTH eyes
  • pus draining from the eye

You may have

bacterial conjunctivitis

Consider using

ofloxacin 1 drop in the affected eye 4 times per day for 7 days

OR

polymyxin B-trimethoprim (generic for Polytrim®) 1 drop in the affected eye every 3 hours while awake for 7 days

OR

erythromycin half inch of ointment in the affected eye every 6 hours for 7 days

and seek emergency medical care

If you have

  • severe eye pain
  • major trauma to the eye
  • blurred vision or seeing floaters/flashes of light
  • vision loss

You may have

retinal detachment or vitreous hemorrhage or globe rupture or acute glaucoma or retinitis

You should

seek emergency medical care

Reference

ofloxacin

Ofloxacin is an antibiotic eye drop. It is used to treat bacterial conjunctivitis (pink eye). It also used to prevent infection in cases of corneal abrasion (a scratch on the eyeball). While ofloxacin is formulated to be used in the eye, it can also be used in the outer ear to treat an outer ear infection (otitis externa) if no other alternative is available. Ofloxacin can be used to treat eye infections in people who normally wear contact lenses, but should never be used at the same time as wearing contact lenses.

Prescription only

InfectionMedication

ketotifen

Ketotifen is an antihistamine eye drop. It temporarily relieves itchy eyes due to pollen, ragweed, grass, animal hair and dander.

GeneralMedication

polymyxin B-trimethoprim

Polymyxin B-trimethoprim (generic for Polytrim) is an antibiotic eye drop.

Prescription only

InfectionMedication

erythromycin

Erythromycin is an antibiotic eye ointment. It is used to treat bacterial conjunctivitis (pink eye). It also used to prevent infection in cases of corneal abrasion (a scratch on the eyeball).

Prescription only

InfectionMedication

proparacaine

Proparacaine is a pain relieving eyedrop that can alleviate pain associated with acute injury to the cornea of the eye.

Prescription only

GeneralMedication

ciprofloxacin ophthalmic

Ciprofloxacin ophthalmic is an antibiotic eye drop. It is used to treat bacterial conjunctivitis (pink eye). It also used to prevent infection in cases of corneal abrasion (a scratch on the eyeball). While ciprofloxacin is formulated to be used in the eye, it can also be used in the outer ear to treat an outer ear infection (otitis externa) if no other alternative is available. Ciprofloxacin drops can be used to treat eye infections in people who normally wear contact lenses, but should never be used at the same time as wearing contact lenses.

Prescription only

InfectionMedication

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