Many treatments of the eye call for patching of the eye. It can offer comfort and may even speed the healing process.
A patch may cause more problems for contact lens users.
Only patch an eye tightly enough to keep the eyelid shut.
Fold a gauze square or eye patch in half and place it over the closed eyelid.
If available, place another patch (unfolded) over the first one and tape completely over the patch from the forehead to the cheekbone.
If a second patch is not available, just tape the first folded one.
Inspect and re-patch every 24 hours if needed, using a clean patch every time.
Do your best to not use the eye, e.g., reading will use both eyes even if one is patched.
Do not use an eye patch if:
Infection is present, e.g., conjunctivitis, corneal ulcer.
Injury was caused by/contaminated with organic matter.
Injury is a penetrating injury; instead, use a donut bandage or protective cup to avoid pressure to the eye.
A foreign object is the most likely cause of eye irritation or pain.
Symptoms of a Foreign Body in the Eye
Irritation.
Pain.
Redness.
Tearing.
Treatment for a Foreign Body in the Eye
Locate the foreign body by examining the corners of the eye and under the eyelids; a moist cotton swab (Q-tip) can be used to lift and invert the eyelid.
Irrigate with drinking quality water (preferably disinfected) from the inside to the outside corner of the eye.
If the foreign body is not removed by irrigation, dab object off the eye with moist gauze.
If foreign body is still not removed, patch the eye for 24 hours and then reattempt removal as previously explained.
After removal, check for corneal abrasion; Diagnoses and Treatments – Head – Eyes – Corneal Abrasion.
A cool compress can soothe.
Pharmaceuticals:
Antibiotic, topical, e.g., erythromycin: apply to inner surface of lid before patching.
A corneal abrasion is a scratch to the cornea.
People that wear contact lenses or have recently had a foreign body in the eye are at higher risk; Diagnoses and Treatments – Head – Eyes – Foreign Bodies.
Grain of sand feeling in the eye.
Irritation.
Redness.
Tearing.
Treatment for Corneal Abrasion
Healing should take a few days depending on the size of the abrasion.
Remove foreign body if present.
Irrigate.
Patch for 24 hours if it makes it feel better; Diagnoses and Treatments – Head – Eyes – Eye Patching.
If not patched, a cool compress can be applied.
If it does not heal in 4 days, gets larger or more painful, seek advanced medical care.
Pharmaceuticals:
Antibiotic, topical, e.g., erythromycin; apply to inner surface of lid before patching.
Acute angle-closure glaucoma (AACG) is when there is a sudden rise of pressure inside your eye, i.e., intraocular pressure. If not treated quickly it may lead to permanent blindness.
AACG may occur when the pupil is more dilated, e.g., watching television in dim light, excitement, stress.
Some medications may also trigger AACG, e.g., chlorphenamine, cimetidine, eye drops that dilate the pupil, general anesthetic, ipratropium (asthma medication), phenothiazines, ranitidine, SSRI (antidepressant), topiramate, tricyclic (antidepressant).
Farsighted individuals are more at risk.
Symptoms of Acute Angle-Closure Glaucoma
Ache around eye.
Blurred or reduced vision.
Dilation of pupil.
Eye feels hard to the touch.
Haloes around eyes.
Headache.
Nausea.
Redness.
Severe pain (sudden).
Vomiting.
Treatment for Acute Angle-Closure Glaucoma
Seek advanced medical care ASAP.
Do not cover.
Adopt a lying-up (supine) position as long as possible.
Pharmaceuticals:
Anti-nausea.
Conjunctivitis (pink eye) is a highly contagious eye infection. It is most common in children.
Eyes ‘glued’ shut.
Itching.
Photosensitivity (sensitivity to light).
Pus and/or milky drainage.
Redness.
Do not patch.
Pharmaceuticals:
Antibiotic, topical, e.g., erythromycin; apply to inner surface of lid.
Alternative/Natural Remedies:
Tea eyewashes:
Ø Chamomile tea (strong).
Ø Baking soda (half a teaspoon in a cup of water).
Ø Honey tea (one tablespoon of honey dissolved in a cup of hot water).
Note: let teas cool before use.
Any of the above eyewashes can also be used as a compress. Apply for ten minutes every couple of hours.
Change contacts often.
Don’t share eye drops, make up etc.
Keep contacts clean, e.g., don’t put them in mouth.
Wash hands regularly.
As the eyelid opens, a small part of the corneal epithelium (the ‘shield’ for the cornea) may be torn. It is more common if there is a history of corneal abrasion, and it often happens when first opening the eyes after sleeping; Diagnoses and Treatments – Head – Eyes – Corneal Abrasion.
Pain.
Photophobia (light sensitivity).
Patch for twelve hours. Re-patch if needed; Diagnoses and Treatments – Head – Eyes – Eye Patching.
Pharmaceuticals:
Antibiotic, topical, e.g., erythromycin (apply to inner surface of lid before patching).
Lubricant eye drops (e.g., Artificial Tears) every several hours.
A corneal ulcer is most commonly due to an infection and usually occurs after an injury and/or the use of soft contact lenses.
People who get a lot of cold sores often develop Corneal Ulcers; Diagnoses and Treatments – Head -Mouth and Teeth – Cold Sores.
Pain.
Photosensitivity (sensitivity to light).
Redness.
White or gray spot.
May have discharge.
Do not patch.
Do not wear contact lenses.
Seek advanced medical care.
Pharmaceuticals:
Antibiotic eye drops, preferably gatifloxacin ophthalmic.
Cycloplegic, e.g., atropine, cyclopentolate.
Contact lenses can often become displaced. It will not go behind the eye.
Symptoms of a Displaced Contact Lens
Blurred vision.
Sensation of foreign body in the eye.
Treatment for a Displaced Contact Lens
Ensure the contact lens is still in the eye as it may have fallen out completely.
Attempt to feel the lens through the eyelid, applying artificial tears may help.
If you can see it, gently slide it back with a finger, and then remove it normally.
If that is not successful, ask the patient to look down as far as possible as you may then see it.
The use of a magnifying lens and light to find it may help.
Several minutes of gentle massaging over the closed upper lid may cause the contact lens to emerge.
If that fails, use upward finger pressure to lift the upper lid from the eye and sweep with a moist cue tip.
As a final option, fluorescein (a special type of dye) can be used to find it.
Giant cell arteritis (temporal arteritis, cranial arteritis) is a swelling of the lining of the arteries, generally in the head.
Symptoms of Giant Cell Arteritis
The main symptom is vision loss which usually affects one eye first. The second eye can be affected within hours or days.
Fever (low-grade).
Headache.
Jaw pain.
Ringing in ears.
Stroke (not common).
Vision loss (rapid and painless).
Treatment for Giant Cell Arteritis
Immediate pharmaceutical treatment is needed to prevent blindness.
Seek advanced medical care ASAP for further treatment.
Treatment should show improvement within a couple of days.
Pharmaceuticals:
Corticosteroid: high dose, e.g., prednisone 100 mg/day.
Hyphema is blood in the front of the eye (the anterior chamber). It is most likely the result of a blunt injury to the eye and is usually not dangerous unless there is a loss of vision.
It is usually due to some kind of blunt trauma to the eye, but very forceful coughing or sneezing may also cause it.
Blood in the eye either as a red tinge or a pool.
Decreased vision and eye pain.
Hyphema will resolve itself after a while.
Sit upright and rest.
Apply a cool compress.
Keep the head elevated.
Treat any abrasions.
Do not patch.
Pharmaceuticals:
No NSAIDs.
Cycloplegic, e.g., atropine, cyclopentolate.
This is obviously a very serious injury, and loss of vision in the affected eye is high, especially in a survival situation.
Treatment for an Impaling Object in the Eye
Stabilize the object.
Patch both eyes; Diagnoses and Treatments – Head – Eyes – Eye Patching.
Seek advanced medical care.
If there is no advanced medical care:
If in a survival situation your options are limited.
If the object is not protruding from the eye it may be possible to let the wound heal over the object, but that will also increase the chance of infection.
Removal of the object is the other option.
A strong magnet may be helpful to remove metal splinters.
Colloidal silver orally as well as an eye wash.
If infection starts then evasive surgery must be considered.
The entire eyeball may have to be removed, which is a very high-risk procedure.
Solar/ultraviolet keratitis (snow blindness) is a burn to the cornea as a result of intense exposure to UV light. It can occur within one hour, although symptoms may not show for up to 12 hours.
Symptoms of Solar/Ultraviolet Keratitis
Delayed onset of severe eye pain.
Impaired vision.
Gritty, burning sensation.
Photosensitivity (sensitivity to light).
Swelling of the eyelid.
Tearing.
Treatment for Solar/Ultraviolet Keratitis
Avoid the sun.
Remove contact lenses (if applicable).
Patch; Diagnoses and Treatments – Head – Eyes – Eye Patching.
Check and replace patch every 12 hours until healed, which is usually within 24 hours. If both eyes are affected and sight is needed, patch the eye that is more severely affected.
Cold compress can relieve pain.
Rest.
Pharmaceuticals:
Antibiotic, topical, e.g., erythromycin; apply to inner surface of lid before patching.
Anesthetic, topical; use only once (to decrease pain during examination).
NSAIDs.
Prevention of Solar/Ultraviolet Keratitis
Protect eyes from glare, i.e., sunglasses, preferably with side shields.
Improvised eye protection can be made by cutting slits in a piece of cardboard, duct tape, fabric etc.
A stye is like a pimple which forms on either the inside or outside of an eyelid. It is due to an infected oil gland and the main cause is poor hygiene.
Discomfort or pain.
Redness.
Swelling.
Styes may last up to 2 weeks but can dissipate much faster if treated properly.
Allow stye to pop on its own.
Very warm moist compresses for 15 minutes, 4 times daily.
Close eye while applying compress.
Pharmaceuticals:
Antibiotic, topical, e.g., erythromycin (apply to inner surface of lid before patching).
Alternative/Natural Remedies:
Eyewashes:
Ø Strong chamomile tea.
Ø Baking soda (1 teaspoon of baking soda in 2 cups of cool water).
Ø Honey tea (1 tablespoon of honey dissolved in a cup of hot water).
Note: let teas cool before use.
Any of the above eyewashes can also be used as a compress. Apply for 10 minutes every couple of hours.