Eyesight is precious and the eyes are fragile. Injuries to the eye can easily be life-changing and career-ending. Fortunately, the vast majority of eye injuries are preventable. Use of the correct PPE, such as safety glasses, is essential. However, because eye injuries cannot always be prevented or forseen, it is important to be able to treat them.

If your place of work does not have readily available and easily accessible clean running water for the purposes of flushing out the eye (e.g. an emergency eye shower, or suitable tap) then action should be taken to ensure that current health and safety regulations are met. This can be done by making sealed eye wash bottles available.

1) For contamination of the eye with dirt, dust, small insects, etc.

Examine the eye

1. Find out what the casualty has been doing and what is likely to be causing their eye irritation/injury
2. Sit the casualty down and stand behind them
3. Ask them to lean back slightly and incline towards the side of the injured eye
4. With your thumb and index finger, gently part the upper and lower eyelids - explain this procedure to the casualty beforehand
5. With the eyelids parted, as the casualty to look up, down, left and right. Look for any foreign bodies on the eye's surface

Irrigate the eye

If issued with sterile eye wash, carry out the following checks:

1. Make sure the bottle is sealed
2. Ensure the product is within its expiry date
3. Check that the contents are not cloudy

If not issued with eye wash, you may use tap water to irrigate the eye using the following steps:

1. Get a small, clean container, preferably plastic
2. Turn on any safe cold drinking water tap and allow to run for 5 seconds
3. Fill the container to 3/4 full

Begin irrigation

1. If possible, place a kidney dish or bowl on the casualty's shoulder with a towel to reduce spillage (the casualty can hold it in place)
2. Inform the casualty of what you are doing and allow a small drop of water to drop onto their cheek; this will ensure they are accustomed to the water temperature of the eyewash
3. Wash the eye out, from the inner corner outward for 10 seconds at a time. Allow the casualty 5 seconds to blink. Carry on until the foreign body has been removed
4. Examine the dish for any sign of foreign bodies
5. If the casualty is experiencing any pain or difficulty seeing, seek medical attention and transport for the casualty whilst keeping both their eye's immobile

2) Eye contamination with chemicals

When the eyes are contaminated with chemicals, the first aider must take care to avoid contact with harmful chemicals themselves, limit the potential for harmful chemicals to contact other parts of the casualty's body, and to flush the chemicals out of the eye(s) as quickly as possible to reduce the chances of permanent damage.

1. Be aware of any dangers
2. Quickly place the casualty in the reclined sitting position. if available, put on gloves.
3. Immediately begin to irrigate the eye with eyewash or tap water. Ensure the water runs away from the casualty's face and never into the other eye. Unless COSHH (Control of Substances Hazardous to Health) data sheet instructs differently, wash the eye for 20 minutes
4. Send a colleague to identify the chemical that caused the injury if not already known. The label may have first aid advice
5. Consult your company's COSHH data sheet for information
6. Cover the eye
7. Seek immediate medical aid

DO NOT:
  • Wash the eye out and send the casualty back to work without a medical opinion
  • Discard any chemical containers. They may have valuable information
  • Attempt to neutralise the chemical with other chemicals, either acids or alkalis

3) Bruised sockets

1. Ensure the casualty does not have any additional injuries to the head or neck. If they have, these must take priority
2. The casualty's eye should be examined as shown in section 2. Care not to exert too much force when opening the eye
3. If any sign of blood is seen leaking into the eye a medical opinion should be sought immediately
4. To reduce swelling and bruising, a cold compress may be lightly applied to injury

The casualty should be referred to medical aid if he or she experiences difficulty in focusing, etc.

4) ARC eye

Over exposure to UV (ultra violet) light sources can be harmful. Most commonly, "arc welding" can cause a painful condition known as "arc eye" or "welders flash".

Symptoms

The casualty may complain that he/she has a severe headache. They may also complain that their eyes feel gritty and will not be keen to have their eyes exposed to any form of light. Sometimes the casualty sees black spots in centre of vision.

Treatment

1. Darken the room
2. Lightly pad both eyes
3. Refer the casualty to hospital

The condition may also develop after exposure to strong sunlight from surfaces such as snow, water or other reflective surfaces.

5) Applying dressings

In general eyes are padded in order to immobilise them and reduce further damage. The eyes have a sympathetic movement system and therefore move as one unit and as such is it is not possible to pad one eye to prevent movement. How you apply dressings to the eye depends on the nature of the injury.

Embedded foreign bodies, major

1. Leave the object in place
2. Lie the casualty down
3. If the object is protruding, immobilise with rolled dressings and gently keep in place until the emergency services arrive. Instruct the casualty to close the other eye / apply a pad to the other eye

Embedded foreign bodies, minor

1. Place a light pad over the affected eye
2. Gently bandage over both eyes
3. Send the casualty to hospital with an escort

6) When calling for emergency help

Lift the receiver and wait for the dialing tone. 
Dial 999 in UK (112 in Europe).
DO NOT Hang up at any stage of conversation. The operator will terminate the call when appropriate. 

The information contained in this article is for guidance only and should not be used in place of recognised training. 

Safety First Aid has a complete range of eyewash products, including eyewash kits, stations and pods as well as eye dressings.