Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Chemical exposure: Even if the eye was irrigated at home, the ophthalmologist or emergency medicine doctor will probably have the eye irrigated again, possibly with a special device resembling a contact lens used for continuous eye irrigation termed a Morgan lens. The chemical involved and severity of the injury will dictate the treatment. For severe exposures, such as acid or alkali, the pupil may be dilated with special eye drops, and pain medicine may be prescribed.
Subconjunctival hemorrhage: Treatment consists of reassurance, avoidance of rubbing the eye, and time.
Numbing eye drops are often used to help examine the eye. Although medicated eye drops remove the pain, they cannot be used at home to control pain. The anesthetic drops actually delay healing. Repeated use will damage the cornea. Dilating the pupil with drops and antibiotic ointments or drops is a commonly utilized technique.
Depending on the ophthalmologist, an eyepatch may be used. Some ophthalmologists believe that the patch provides symptomatic relief and speeds healing. Others believe that the increased risk of infection with a patch, particularly in people who wear contact lenses, outweighs the potential benefits.
Traumatic iritis: Eyedrops are used to dilate the pupil. Steroid eyedrops may be helpful to decrease inflammation.
Hyphema: People with significant hyphemas may be hospitalized and placed on bed rest with their head elevated. A protective rigid shield may be placed over the eye, and the pupil is dilated with drops. People who will follow the ophthalmologist's instructions with small hyphemas may be managed at home.
Orbital blowout fractures: Ice and elevation of the head for 48 hours are recommended to reduce swelling. People are advised not to blow their nose as the pressure generated may pass through the fractured area and cause further problems. Some ophthalmologists use nasal decongestants and oral antibiotics for
1 to 2 weeks. If any surgical repair is needed, it is usually done a few days to 1 week later when the swelling has gone down.
Lacerations: Depending on the size and location of the laceration, suturing (stitches) may be necessary. If the cut is in a noncritical location, the laceration may be left to heal on its own. Lacerations to the eyeball often require antibiotics, sutures, and more extensive surgery in an operating-room setting.