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Treating Eye Injuries

Posted September 28, 2015

By Mike McKenney, MS, ATC

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/uc...

About the Author

Mike mckenney

Mike McKenney is an Athletic Trainer (AT) at Northeastern University in Boston, Massachusetts, where he is the Medical Coordinator for their Division I men’s ice hockey program. Prior to Northeastern University, he served as an AT in multiple settings including secondary schools, Division I athletics and professional cycling; additionally, he worked as an AT who extends the services of a physician for a large orthopedic group. He has also provided services for many organizations to include the Boston Marathon, USA Cycling and USA Volleyball. McKenney is a hydration and electrolyte replacement consultant for the Atlanta Hawks of the NBA. His professional interests include hydration, electrolyte replacement, thermoregulation in sport and postural restoration. McKenney completed his athletic training education at Gustavus Adolphus College in Saint Peter, Minnesota and master’s degree at North Dakota State University in Fargo, North Dakota. His graduate research was published in the February 2015 edition of the Journal of Athletic Training.

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