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Treating Eye Injuries

By Mike McKenney, MS, ATC, NASM-CES

As Athletic Trainers, eye injuries are not the most common injury we treat, but when they occur, they can have sport- and life-altering results if not cared for properly.  It is estimated roughly a third of eye injuries that result in blindness are from sports-related injuries.1  Sports also account for 13 percent of penetrating ocular injuries nationwide, with the vast majority of these patients wearing no eye protection at all.1  Since Athletic Trainers are often present in environments with balls, bats, pucks and other objects moving at high velocities, it is imperative that eye injuries are treated appropriately and have proper return-to-play criteria.

One of the first things Athletic Trainers should do is create a plan for treating eye injuries.  Athletic Trainers should work with a team physician to create a referral network that includes an ophthalmologist or optometrist who can be consulted should an eye injury occur. This referral network will be highly beneficial to your patients since treatments for eye injury are highly specialized and time-sensitive.  If a severe eye injury occurs, the return-to-play criteria should include clearance from an ophthalmologist.1,2

In addition to a sound referral plan, you should also have a series of simple supplies on hand that can make evaluation of eye injuries easier for you and your team physician:1,2

- Ophthalmoscope

- Penlight

- Light source with blue or cobalt filters

- Vision chart

- Cotton-tipped swabs

- Saline

- Magnifying glass

- Eye shield

- Medications at the discretion of your team physicianInjuries resulting in blunt force trauma make up the majority of what Athletic Trainers see in a traditional setting.  However, with expansion into industrial settings, Athletic Trainers need to be prepared to recognize other types of injuries such as corneal foreign bodies and lacerations around the eyelid.  Additionally, a thorough history during a vision assessment can identify more subtle injuries such as non-traumatic retinal detachment.1,2

The behavior of athletes who wear contact lenses can create health-related issues that can negatively impact sport participation.  Athletic Trainers should make it a point to educate these individuals.  According to the FDA, improper care of contact lenses can result in "Discomfort, excess tearing or other discharge, unusual sensitivity to light, itching, burning, gritty feelings, unusual redness, blurred vision, swelling and pain."3 In order to prevent these symptoms, the FDA recommends:

- Replacing contact storage cases every 3-6 months

- Never re-use lens solution. Always discard after each use

- Do not use non-sterile water as a contact lens solution, especially tap water

- Do not use expired contact lens solution

- Do not borrow or re-use a friend''s contact storage case

- Do not sleep while wearing contact lenses unless they are specifically designed for that purpose3

In conclusion, Athletic Trainers should review policies to ensure they have an eye treatment plan in place. Furthermore, they should also educate athletes with corrected vision on proper care of contact lenses.

Resources:

1. Cass, SP. Ocular injuries in sports. Head and Neurological Conditions. 2012;11(1):11-15

2. Pujalte, GGA. Eye injuries in sports. Athletic Therapy Today. 2010;15(5):14-18

3. Food and Drug Administration: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048893.htm