Fluorescein staining will aid in identification of abrasions to the conjunctiva and cornea. Fluorescein uptake is yellow in color under normal lighting conditions and will appear green under the blue filter of the ophthalmoscope.
Small abrasions can often be safely treated in most primary care practices with topical antibiotics and careful follow-up in 24 hours. If these abrasions cross the visual field of the cornea, appear deep, have an embedded foreign body or display a dendritic pattern, or if injury occurred more than 24 hours prior and was caused by metal or wood, the patient should be immediately referred to an ophthalmologist. Serious complications including permanent vision loss can result with delay in referral for serious eye injury.9
While we cannot prevent all eye injuries to our patients—or even to ourselves—we must be prepared to empower our patients with education and strategies to keep us all seeing well into the future.
1. American Academy of Ophthalmology. Eye health statistics at a glance (2011). www.aao.org/newsroom/upload/eye-health-statistics-april-2011.pdf. Accessed June 10, 2013.
2. CDC. Healthy vision: make it last a lifetime (2013). www.cdc.gov/features/healthyvision. Accessed June 10, 2013.
3. US Department of Health and Human Services. Vision: topics and objectives. Healthy People 2020. www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topi.... Accessed June 10, 2013.
4. American Academy of Ophthalmology and American Academy of Pediatrics. Joint policy statement: protective eyewear for young athletes (2013). one.aao.org/ce/practiceguidelines/clinicalstatements_content.aspx?cid=1fda605b-97b9-47e3-90d1-11b7a9607797. Accessed June 10, 2013.
5. Heiting G. Ultraviolet radiation and your eyes (2013). www.allaboutvision.com/sunglasses/spf.htm. Accessed June 10, 2013.
6. American Academy of Ophthalmology. Policy statement: guidelines for appropriate referral of persons with possible eye diseases or injury (2009). www.aao.org/about/policy/upload/Guidelines-for-Appropriate-Referral-2009.... Accessed June 10, 2013.
7. Hodge C, Lawless M. Ocular emergencies. Australian Fam Phys. 2008;37:506-509.
8. Joseph J, Glavas I. Orbital fractures: a review. Clin Ophthalmol. 2011;5:95-100.
9. Wipperman J, Dorsch J. Evaluation and management of corneal abrasions. Am Fam Phys. 2013;87(2):114-12