Eye Emergencies In The Wilderness
You are backpacking with friends 2 days away from the trail-head. Your roommate and part time half genius (that is half) just finished making smores, walked over to share, and tripped on his untied shoelaces. After the laughter is over he realizes there is hot chocolate and marshmallows on his eye. Now everyone is really upset because who wastes chocolate?
Eye Burns To The Cornea Hurt!
Burns to the cornea, the clear tissue covering the colored iris, are similar to burns to the skin. They can be to the surface layer, partially thickness, or full thickness burns to the eye. Fortunately, most are superficial. The eye is exquisitely supplied with nerves and even small burns or trauma to the cornea can result in highly elevated levels of pain. Most of the time the pain will need to be managed with the best means you have available. Eye doctors will usually prescribe cycloplegic drops to keep the afflicted eye dilated. This is the equivalent of splinting the iris (the colored tissue in the eye). Much of the photophobia (light sensitivity) from eye trauma is related to the movement of the iris as it continually adjusts to changing light levels and focusing. This is also correlated with eye pain, When the eye stays dilated it not only reduces pain but also assists in the healing process. Dark sunglasses will not eliminate changes in the pupil size but they will reduce the magnitude and provide some relief. Unfortunately, occluding one eye does not reduce pupil and iris movement in the covered eye. If both eyes were covered it would reduce the discomfort, but this is not acceptable to most people. Find the darkest sunwear you can. If your medical advisor permits, you can treat the pain with alternating doses of ibuprofen and acetaminophen every 2 hours. Sometimes they are stacked together at the same time instead for maximum pain relief. Know the maximum daily dosage. Burns to the cornea may require stronger pain management than over the counter remedies can provide for adequate short term relief. A patch over the eye for 24 hours that exerts mild pressure to lessen eye movements may help the cornea get a start on healing.
Cool And Flush The Eyes
Like burns to the skin it is important to lessen damage by cooling the corneal tissue as rapidly as you can. Contact lens solution or the closest thing to sterile water should be used for 5-10 minutes if possible. Flushing the eye will help remove any foreign materials that are lodged on the surface. Try to have the person alter their gaze in different directions to improve the rinsing. A longer rinse can be used if there is concern about material adhering to the surface of the eye. Cold compresses can be applied over a closed eyelid for discomfort as needed after the injury. Keep the eye moist with sterile eye drops after the injury. Artificial tears or contact lens re-wetting drops can be used for this.
Prescription Eye Drops
If your protocol allows, topical antibiotic eye drops or ointment should be used to prevent eye infections that can occur while the eye is compromised during the healing process. The cornea will regenerate cells rapidly in the first 48 hours but can take a week or longer to fully heal.
Parting Thoughts
The cornea is resilient but eyes are not replaceable. If you think it is more than a superficial injury you should evacuate and seek care. The eye should be feeling much better in 24 hours in most cases. If it is not, or the vision and discomfort are getting worse, make a beeline for the trail-head. Injuries outdoors increase the risk for more exotic secondary infections. Prevention is always the best treatment.
This information is intended for educational purposes only and should not be used as a basis for treating any eye problems. Treatment protocols may vary greatly depending on the individual circumstances.