The client sustains a contusion of the eyeball following a traumatic injury with a blunt object. Which intervention is initiated immediately?
A. Notify the physician.
B. Irrigate the eye with cold water.
C. Apply ice to the affected eye.
D. Accompany the client to the emergency room.
Correct Answer: C. Apply ice to the affected eye.
Treatment for contusion begins at the time of injury. Ice is applied immediately. The client then should be seen by a physician and receive a thorough eye examination to rule out the presence of other eye injuries. This injury is usually benign, but the patient should be assessed for more serious injury, such as a hyphema or basilar skull fracture. Symptoms usually include ecchymosis of the lids, which can make it very difficult to visualize the globe.
Option A: If the globe appears intact, rule out orbital fracture and hyphema. If no obvious associated problems are identified, therapeutic interventions such as ice, head elevation, and reassurance are initiated. Resolution of uncomplicated periorbital ecchymosis usually occurs within 2 to 3 weeks.
Option B: Do not instill eye drops before evaluation of ocular injury. Severe pain associated with ocular trauma can be minimized without medication by patching both eyes. When the patient cannot blink, protect the cornea from drying with ophthalmic ointment or artificial tears.
Option D: General principles pertaining to ocular examination are essentially the same for the patient with an eye injury; however, the patient’s ABCs should be evaluated and stabilized before interventions for the ocular problem. Ocular injury often occurs in conjunction with head and facial trauma; therefore these patients should be carefully evaluated for an associated eye injury.
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