Eye Care Blog

The eye has its natural protective mechanisms. The lids, for example, protect the front of the eye from dust, wind and objects coming towards the face. They also protect the eye from excessive light. The eye itself is set in its bony cavity: the orbit. In the orbit there are some soft fatty tissues which act as a cushion, permitting the eye to sustain a light blow without injury. Nevertheless the eyes are vulnerable. The eye will be injured, often severely, by fast-flying hard objects, and also by some gases and solutions. It is easy to incapacitate a human being, either temporarily or permanently, by spraying irritant solutions onto the face, and such methods have been widely used by criminals, police and the armed services. But irrespective of whether the damage is caused by accident or on purpose, or whether it is caused in the home, at work or at school, the results are best discussed under physical categories. Thus there are burns caused by chemicals or heat; there are radiations, such as X-ray, cosmic, infra-red and ultra-violet, and even intense light (laser); there are contusions and concussions from blunt objects; and finally there are lacerations made by more penetrative objects.

The commonest chemical burn to the eye is made by alkalis such as lime and caustic soda commonly used in industry and sometimes in the home, and in criminal assault. Next come burns from acids such as hydrochloric acid. Most commonly an acid burn is incurred as the result of the spitting of the liquid. Sometimes the acid will hit the hands, sometimes the face, and sometimes, more unfortunately, the eyes. A very small amount of acid, if it is sufficiently concentrated, can in the latter case cause substantial injury. A good example of a frequent accident involving an acid is the explosion of a car battery following the incorrect placing of jump-leads. The first-aid treatment is simple: water, preferably from a running tap, applied copiously to the affected eye. (Water dilutes acids, and enough water will dilute them completely.) Then the eyes should be covered either with sterile eye-pads or clean handkerchiefs kept in position by some kind of bandage until specialized hospital treatment can be given. Although there are some special anti-acid solutions available on the market for just such an emergency, it is always better to apply water immediately than to wait while someone runs off for the medical chest. Unfortunately the initial damage done by the chemical can be very serious. The conjunctiva and lids can be so severely affected that they swell up to the point where the eye itself cannot be examined for days without expert handling by specialists. As a rule, and whatever the circumstances, if the tissues round the eye make it impossible to open the eyelids, qualified help should be sought immediately. Many chemicals are quite capable of passing through the cornea and causing havoc inside the eye, so that the final result can be blindness, whatever the initial care and attention given to the victim. In lower degrees of chemical injury, the inside of the lids have to be kept away from the globe of the eye, otherwise the inflamed tissues stick together and will cause blindness through eventual collapse of the eye-lubricating system. Depending upon the severity of the injury some scarring of the cornea and lids may be inevitable, causing future discomfort and perhaps some loss of vision.

Treatments for chemical burns to the eye are available, but they are of limited efficiency. The final outcome will always depend on the initial damage wrought by the chemical. Heat burns likewise can produce tissue damage, but here the final outcome is marginally better, although the period of treatment is usually a long one. Skin-graft surgery may be necessary, particularly where the whole face has been affected. Generally speaking, injury from fire does not cause great damage to the inside or back of the eye, although extensive surgery may still be necessary to restore sight. Heat burns may also be caused by electric shocks of high voltage. There are some instances where an electric shock has caused damage to the inner lens of the eye, but generally a current strong enough to do that will also be strong enough to kill the patient anyway.

Next, radiations. The radiations present naturally on the earth’s surface vary from those of little energy to those of intense energy. And whilst one tends to think of the light emanating from an electric light bulb and the invisible rays emanating from an X-ray tube as being different kinds of phenomena, they do in fact belong to the same order of physical activity. Simply, light is spread across a spectrum only part of which is used for seeing in the normal sense of the word. X-rays, ultra-violet light and infra-red all emanate at different parts of the spectrum. The radiations emitted by high energy-sources such as the sun or a man-made machine are the reason for life on this planet, and also the reason for eventual death. In outer space there are forms of radiation we as yet know very little about, but we do know that, at high altitudes, there are radiations not present in any meaningful quantity at sea level.

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