Primary level management of eye injuries

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Eye injuries are common and a leading cause of preventable unilateral blindness worldwide. The causes vary, but drawing upon experience from The Gambia and Senegal, trauma is more common during the farming season and among small-scale metal workers working without eye protection. Stick injury is common in children and farmers, sometimes causing a penetrating injury that can result in the affected eye quickly becoming infected. Blunt trauma is common among children, who can be injured with a catapult or stone. The dusty environment is a common cause of corneal, conjunctival and sub-tarsal foreign bodies injuries.

Injuries are often preventable which makes education at the community level important. Village health workers and community-based volunteers (such as ‘Nyateros’ or ‘Friends of the Eye’ in The Gambia) are important promoters of good eye health practices.

A network of community ophthalmic nurses can provide appropriate first aid and refer from village level to secondary or tertiary care. This can significantly reduce visual impairment and blindness resulting from injuries. Health facilities should be ready to deal with eye injuries by:

• ensuring that staff know how to assess eye injuries and perform basic first aid procedures appropriate to their level of training
• ensuring a supply of equipment, drugs and consumables required to assess and provide first aid for eye injury
• having a plan of how to refer patients, including nearest referral facilities, and options for transporting patients in an emergency.

The chart below provides an easy reference for community level workers faced with an eye injury in their clinic or community.

First aid management of eye injuries

Cause of injury

Management