Eye Injuries in Children: First Aid and Prevention

Children's eyes are both resilient and vulnerable. While minor irritations are common and usually resolve easily, serious eye injuries require prompt attention to prevent permanent damage. Knowing how to respond—and what NOT to do—can protect your child's vision.

Types of Eye Injuries AAP

Minor irritations:

• Foreign body (dust, eyelash, sand)
• Minor scratches
• Allergic reactions
• Mild chemical exposure (soap, shampoo)

Moderate injuries:

• Corneal abrasion (scratch on eye surface)
• Subconjunctival hemorrhage (blood on white of eye)
• Black eye (bruising around eye)
• Chemical splash

Serious injuries:

• Object embedded in eye
• Deep cuts to eye or eyelid
• Blunt trauma (hit by ball, fist, etc.)
• Chemical burns
• Eye puncture

Foreign Bodies in the Eye AAP

Most common scenario—something in the eye:

What to do:
1. Wash your hands
2. Don't let child rub the eye (makes it worse)
3. Blink several times—tears may flush it out
4. Rinse with clean water or saline
5. Use an eye cup or hold eye open under gentle stream
6. Pull upper lid over lower lid (lashes may sweep it out)

What NOT to do:

• Don't rub the eye
• Don't use tweezers or cotton swabs on the eye
• Don't try to remove anything embedded in the eye
• Don't touch the eye with dirty hands

Seek medical care if:

• Object doesn't flush out easily
• Object appears embedded
• Pain continues after flushing
• Vision is affected
• The foreign body is metal, glass, or chemical

Chemical Exposure AAP

This is time-critical—begin flushing immediately:

### Step 1: Flush Immediately

• Use clean water, saline, or any neutral liquid
• Hold eye open and flush for 15-20 minutes minimum
• Don't waste time looking for special solutions—start with tap water
• Flush from the inner corner outward (nose side out)

### Step 2: Continue Flushing

• Really commit to 15-20 minutes—it feels long but is necessary
• If both eyes affected, alternate or flush both at once

### Step 3: Get Medical Care

• Go to ER after flushing
• Bring the chemical container if possible (or take a photo)
• Call Poison Control: 1-800-222-1222 for additional guidance

Alkali burns (cleaners, drain openers, lime) are typically more serious than acid burns.

Cuts to the Eye or Eyelid AAP

For cuts or lacerations around the eye:

What to do:
1. Don't apply pressure to the eye itself
2. Cover loosely with a clean shield or cup (not fabric directly on eye)
3. Keep child calm and still
4. Go to ER immediately

What NOT to do:

• Don't rinse with water if eye is cut
• Don't remove objects stuck in eye
• Don't apply pressure to the eyeball
• Don't give food or drink (surgery may be needed)

Blunt Trauma (Black Eye) AAP

Hit by a ball, fist, elbow, or object:

What to do:
1. Apply cold compress (ice wrapped in cloth) for 15-20 minutes
2. Repeat cold compresses several times in first 24-48 hours
3. Watch for warning signs
4. Keep head elevated

See a doctor if:

• Vision changes (blurry, double, decreased)
• Pain is severe
• Blood visible inside the eye (around iris)
• One pupil larger than the other
• Eye doesn't move normally
• Deformity of eye socket or face
• Blood or clear fluid from nose
• Persistent headache or vomiting

Most black eyes are minor and will heal with time. Bruising around the eye looks alarming but is often just superficial.

Signs of Serious Eye Injury AAP

Seek emergency care for any of these:

• Visible damage to the eye
• Object stuck in eye
• Blood inside the eye (in front of iris)
• Unequal pupil size
• Eye doesn't move normally
• Eye appears sunken or protruding
• Significant vision change
• Severe pain
• Cut that goes through the eyelid
• Chemical burn

These require immediate professional care—minutes can matter.

Corneal Abrasion (Scratched Eye) AAP

A scratch on the eye surface is painful but usually heals well:

Symptoms:

• Pain (often described as "something in my eye")
• Tearing
• Light sensitivity
• Redness
• Blurred vision

What to do:

• Try to keep eye closed (blinking irritates it)
• Don't rub
• See a doctor—prescription drops speed healing and prevent infection
• Follow up as directed

Most corneal abrasions heal in 24-48 hours with proper care.

Subconjunctival Hemorrhage (Blood on Eye) AAP

Looks scary but is usually harmless:

• Blood between clear membrane and white of eye
• Caused by coughing, straining, minor bumps, or sometimes no clear cause
• No treatment needed
• Resolves in 1-3 weeks
• Vision is not affected

See a doctor if:

• Pain accompanies the redness
• Vision changes
• History of trauma
• Recurs frequently
• Child has bleeding disorders

Eye Protection and Prevention AAP

Sports eye protection:

• Polycarbonate lenses or goggles for sports
• Critical for: basketball, baseball, racquet sports, hockey
• Regular glasses don't provide adequate protection
• Goggles should meet ASTM standards

At home:

• Store chemicals and cleaning supplies securely
• Supervise use of scissors, tools, and projectile toys
• Avoid pointy toys for young children
• Be careful with rubber bands and bungee cords
• Use caution with champagne corks, bottle caps

Fireworks:

• Best avoided at home
• Attend professional displays instead
• If using: adults only, no sparklers for young children, protective eyewear

Sun protection:

• Sunglasses with UV protection
• Hats with brims
• Important even on cloudy days
• Start young to establish habits

Emergency Eye Care Kit

Keep accessible:

• Saline eyewash or bottled water
• Clean cloths
• Disposable eye cup (or small plastic cup)
• Phone number for ophthalmologist/optometrist
• Poison Control number: 1-800-222-1222

Common Questions

Can I use eyedrops?

• Artificial tears: generally safe for minor irritation
• Prescription drops: only as directed
• "Get the red out" drops: not recommended for children

Should I patch the eye?

• Usually not recommended except as directed by a doctor
• Patching can increase bacterial growth
• Patching may be used for corneal abrasions

When can my child return to sports after an eye injury?

• Depends on the injury
• Follow doctor's guidance
• Wear protective eyewear when cleared

The Bottom Line

For chemical exposures, flush immediately for 15-20 minutes before doing anything else. For objects in the eye, try gentle rinsing but don't probe or rub. For trauma, protect the eye without pressure and seek care for anything beyond a minor black eye. Many eye injuries are preventable with protective eyewear in sports and careful supervision at home.

Clara can help you assess eye injuries and determine when professional care is needed!