6 Eye Emergencies from Accidents — Act Fast to Prevent Vision Loss

The Royal College of Ophthalmologists of Thailand has released public health guidance on six types of eye emergencies caused by accidents. The information is intended for general awareness and cannot replace individual medical advice; anyone with symptoms should consult an ophthalmologist promptly.

1. Ruptured Eyeball or Penetrating Foreign Object
Severe trauma or sharp objects can rupture the eyeball or lodge foreign material inside. The outcome depends on the depth and location of the wound, initial vision at the hospital, type of material involved, and how quickly surgery is performed. Early surgical repair within 12–24 hours greatly improves the chance of recovery and reduces complications such as infection, retinal detachment, or long-term eye atrophy.
Do not press or rub the eye, pull objects out, or strain (cough, sneeze, bear down). Shield the eye with a clean cup or eye protector and go to the hospital immediately.

Warning signs: sudden vision loss, open eye wound, irregular or displaced pupil, swelling or bleeding of the conjunctiva, tissue protruding from the wound, internal bleeding, or low eye pressure.

2. Chemical Burns
Chemical exposure can damage eye tissues. Hospital treatment includes antibiotic and anti-inflammatory eye drops, pain relief, and medications to lower intraocular pressure. Severe cases may require surgery, such as eyelid closure, amniotic membrane grafts, or corneal transplantation.

3. Retrobulbar Hemorrhage (Bleeding Behind the Eye)
A heavy blow to the face or some post-surgery complications can cause rapid bleeding behind the eye, raising orbital pressure and threatening sight.
Symptoms: sudden eye bulging, intense pain, sudden vision loss, immobile eye, or fixed dilated pupil.
First aid: do not press or massage the eye, apply a light cold compress, keep the head elevated, and get to a hospital within 60–90 minutes.

4. Torn Tear Duct (Lacrimal Duct Injury)
Sharp trauma near the inner corner of the eye — from nails, animal bites, or falls — can tear the tear duct that drains tears into the nose. Clean the wound gently with sterile water or saline, avoid rubbing, and see an ophthalmologist within 24–48 hours to prevent permanent tearing.

5. Traumatic Optic Nerve Injury
Head or facial trauma from falls, crashes, or heavy blows can injure the optic nerve, disrupting signals between the eye and brain.
Symptoms: immediate loss or reduction of vision, dim or shadowy sight, blind spots, poor pupil reaction to light, or eye-area pain.
Limit head movement and seek care at a hospital equipped with CT or MRI imaging.

6. Orbital Floor Fracture (Blowout Fracture)
A punch, ball impact, or collision can fracture the thin bone beneath the eye, causing the eye to sink or trapping eye muscles.
Symptoms: swelling, bruising, sunken eye, double vision (especially when looking up), restricted eye movement, numbness under the eye or cheek, and in children, nausea or vomiting. Avoid forceful nose-blowing, apply a light cold compress, keep the head raised, and have a CT scan done.

When to See a Doctor
Any eye injury should be taken seriously, even if it seems minor or shows no bleeding. Seek immediate medical attention if you experience: sudden vision loss or blurring, double vision, severe eye pain, immobile eye, excessive tearing, bulging, swelling, or a sunken eye. Prompt care greatly reduces the risk of permanent blindness.

 

Source:

www.thaihealth.or.th