According to the World Health Organization, over 55 million eye injuries occur each year worldwide. Eye injuries can occur at any age and are common in toddlers and children as well as adults.
The eye is a very complex and delicate organ, so there are many ways that damage can be caused as well as numerous different types of eye injuries. Eye injuries can cause permanent vision impairment or blindness, meaning that early recognition of injury and medical intervention is crucial. Prompt treatment also reduces the risk of infection and improves vision outcomes for patients.
This article discusses the nature and causes of eye injuries in children, as well as tips for parents to help prevent them from occurring.
Types of eye injuries
Eye injuries are classified as 1 of 3 types:
- Open globe: Causing full breakage of the cornea and the sclera, the outer layer of the eye.
- Closed globe: Causing partial damage to the cornea and sclera — not full breakage.
- Periocular: Injury occurring around the eye.
The classification depends on the extent of the injury and whether it occurs in the eye itself (ocular trauma) or in the eye socket (periocular trauma).
Common eye injuries include:
- Eyelid laceration: Eyelid lacerations are cuts in the eyelids. In children, eyelid lacerations are most often causes by dog bites, handlebar injuries, and collisions with sharp objects such as sticks and thorns, usually while running.
- Corneal abrasion and foreign bodies: Corneal abrasions are superficial scratches on the cornea, which is the eye’s protective outer layer. Abrasions can be caused by foreign bodies in the eye, such as particles of sand, dirt, or dust. These are common in children, especially those who play outdoors or in sandpits.
- Conjunctival abrasions: The conjunctiva is the lining of the upper and lower eyelids. Conjunctival abrasions are cuts to the conjunctiva resulting from blunt injuries and chemical or thermal burns.
- Hyphema: Hyphema is when blood leaks into the outer chamber of the eye. It can be caused by blunt trauma and penetration injury to the eye. Hyphema is a serious injury that can result in permanent loss of vision.
- Vitreous hemorrhage: Vitreous hemorrhage describes the leakage of blood into the vitreous chamber of the eye. The vitreous chamber is the largest chamber in the eye, located between the lens and the optic nerve. This injury can occur due to abusive head trauma in children.
- Retinal trauma: The retina is the sensory membrane at the back of the eye containing light-sensitive nerves. Retinal trauma refers to various types of injuries that can happen to this layer, including retinal detachment, hemorrhage, tearing, and breakage.
Eye injuries are easily sustained in a number of settings. Older children involved in sporting activities are at risk of eye injuries from equipment, balls, or pucks. They might also get injured through inadvertent contact, such as an elbow or fist to the eye.
Younger children often suffer eye injuries while playing and exploring, with accidents commonly occurring both indoors and outdoors. They can get hit with objects such as toys, fingernails, and curtain rods. Outdoor hazards include tree branches, vegetation, stones, sand, and dirt. Other causes of eye injuries are fireworks, airsoft pellet guns, scissors, and chemicals.
Although it’s simply not possible to protect your child every minute of the day, you can teach them how to stay safe and protect their eyes from injury.
The following tips are helpful for both parents and children to prevent eye injuries:
- Avoid touching your eyes when handling paint, soap, sand, dirt, or chemicals, and always wash your hands afterward.
- Wear the appropriate eye protection for sports and other activities that require them.
- Wear sunglasses in strong sunlight to protect your eyes from UV rays, and never look directly at the sun.
- Keep chemicals and cleaning products securely stored away from children and use protective eye gear when mixing chemicals to protect your eyes from splashes and fumes.
- Shield your eyes when walking or playing in dense foliage to avoid injury from twigs and thorns.
- Do not spray water into other peoples’ eyes with hoses or water guns.
- Take care to direct spray nozzles away from eyes when spraying perfume, deodorant, air freshener, or other aerosols.
- Keep children away from high-powered gardening equipment such as lawnmowers and leaf blowers when they are in use. Grass, sticks, stones, and other debris can be thrust into the air and potentially into their eyes.
- Avoid rubbing your eyes too hard or too often, as doing so can cause injury to the lens and cornea.
- Négrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998 Sep;5(3):143-69. doi: 10.1076/opep.220.127.116.1164. PMID: 9805347.
- Kuhn F, Morris R, Witherspoon CD, Mann L. Epidemiology of blinding trauma in the United States Eye Injury Registry. Ophthalmic Epidemiol. 2006 Jun;13(3):209-16. doi: 10.1080/09286580600665886. PMID: 16854775.
- Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am. 2002 Jun;15(2):139-43, v. doi: 10.1016/s0896-1549(02)00004-4. PMID: 12229228.
- Kennedy RH, May J, Dailey J, Flanagan JC. Canalicular laceration. An 11-year epidemiologic and clinical study. Ophthalmic Plast Reconstr Surg. 1990;6(1):46-53. PMID: 2268600.
- Wipperman JL, Dorsch JN. Evaluation and management of corneal abrasions. Am Fam Physician. 2013 Jan 15;87(2):114-20. PMID: 23317075.
- Spector J, Fernandez WG. Chemical, thermal, and biological ocular exposures. Emerg Med Clin North Am. 2008 Feb;26(1):125-36, vii. doi: 10.1016/j.emc.2007.11.002. PMID: 18249260.
- Lambert SR, Johnson TE, Hoyt CS. Optic nerve sheath and retinal hemorrhages associated with the shaken baby syndrome. Arch Ophthalmol. 1986 Oct;104(10):1509-12. doi: 10.1001/archopht.1986.01050220103037. PMID: 3767684.
- Goldstein MH, Wee D. Sports injuries: an ounce of prevention and a pound of cure. Eye Contact Lens. 2011 May;37(3):160-3. doi: 10.1097/ICL.0b013e31821790db. PMID: 21471814.
- Ramstead C, Ng M, Rudnisky CJ. Ocular injuries associated with Airsoft guns: a case series. Can J Ophthalmol. 2008 Oct;43(5):584-7. doi: 10.3129/i08-131. PMID: 18982037.