Eye injury: which symptoms mean you need an eye exam

Introduction

A blow to the eye can happen during sports, a fall, an accident at home, a car crash or from being hit by an object. Some injuries are limited to the tissues around the eye, but others can affect the cornea, iris, lens, retina or even the bones of the eye socket.

That is why it is not a good idea to judge how serious it is by appearance alone. An eye can look fairly normal after an impact and still have internal changes that can only be detected with an eye exam.

In this guide you'll find which symptoms to watch for, what first aid measures are appropriate and when it is important to seek urgent evaluation.

01 What can happen after a blow to the eye?

The force of the impact can be transmitted to different parts of the eye. Depending on its strength, the object involved and the area affected, problems can range from mild to injuries that threaten vision.

• Swelling and bruising around the eye.
• Scratches or injuries to the surface of the eye.
• Bleeding in the front part of the eye.
• Inflammation inside the eye.
• Changes in the pupil.
• Injuries to the lens.
• Vitreous hemorrhage.
• Damage to the retina or optic nerve.
• Fractures of the bones around the eye.

Some complications show up right away and others appear hours or days later, so it is important to watch how symptoms evolve.

02 Symptoms to watch for after a blow

After an injury it is common to have pain, swelling or tenderness. However, certain symptoms need closer attention.

If any of these symptoms appear suddenly, get worse or come with reduced vision, a prompt eye exam is recommended.

03 What to do right after the blow

1. Don't rub or press on the eye

Don't rub the eye or try to "fix" the area. If there is an internal injury, pressure can make it worse.

2. Apply a cold compress around the eye

If there is only external swelling and no open wound or embedded object, you can place a cold compress on the tissues around the eye with very light pressure. Don't put ice directly on the skin or press on the eyeball.

3. Rest and avoid risky activities

Stop sports, intense exercise and any activity where you could take another hit until you know the eye is fine.

4. Check the vision of each eye separately

Without straining, check whether you can see equally clearly with both eyes. A new difference in vision is a sign to get checked.

5. Get evaluated if there are warning signs

When there are vision changes, significant pain, bleeding, deformity or a high-energy injury, medical evaluation should not be delayed.

04 What NOT to do after an eye injury

• Don't rub or press on the eye.
• Don't use eye drops with antibiotics, anesthetics or steroids unless a doctor prescribes them.
• Don't put ice directly on the eye.
• Don't try to remove an embedded object.
• Don't drive if your vision is blurred or double.
• Don't go straight back to sports if you still have pain or vision changes.
• Don't ignore symptoms that appear several hours after the blow.

05 When should you go to the emergency room?

Seek medical care immediately after a blow if you have any of the following signs:

• Partial or total loss of vision.
• Double vision or blurred vision that doesn't improve.
• Severe or worsening pain.
• Blood inside the eye or bleeding around the eye.
• A misshapen pupil or one that is a different size from the other eye.
• Destellos, a sudden shower of floaters or a shadow in your field of vision.
• Nausea or vomiting along with significant eye pain.
• Being unable to move the eye, or pain when moving it.
• An open wound, deformity of the eye or an embedded object.
• An injury from an object thrown at high speed.

06 What will the ophthalmologist check?

The evaluation will depend on the type of accident and the symptoms. The specialist may check visual acuity, the surface of the eye, the pupil, eye movements and the internal structures.

• Measuring the vision in each eye.
• Slit-lamp examination.
• Checking the cornea, iris and anterior chamber.
• Evaluating the lens.
• Measuring eye pressure when it is safe to do so.
• Examining the retina and optic nerve.
• Imaging tests if a fracture or deep injury is suspected.

The goal is to identify both immediate injuries and possible complications that need follow-up.

07 Complications that can appear later

Some injuries caused by a blow can develop over time. Complications the ophthalmologist may monitor include:

For this reason, after certain injuries follow-up visits may be needed even when the initial symptoms improve.

08 How to prevent eye injuries

• Wear proper eye protection during sports or work with a risk of impact.
• Wear safety glasses when cutting, drilling, sanding or working with tools.
• Don't point toys, projectiles or devices at anyone's face.
• Keep sharp objects out of children's reach.
• Wear a seat belt when traveling by car.
• Follow face protection recommendations in contact sports.

Proper eye protection can significantly reduce the risk of serious injuries.

09 Frequently asked questions

Does a minor blow to the eye always need an exam?

Not every blow needs urgent care, but it is a good idea to get evaluated if there is significant pain, vision changes, bleeding, severe swelling or if the impact was strong.

Can I put ice directly on it?

No. The cold compress should be placed on the tissues around the eye without pressing on the eyeball.

What does it mean to see flashes after a blow?

Flashes can appear when there is pulling or irritation of structures inside the eye. If they are new, especially if they come with many floaters or a shadow in your vision, they need a prompt evaluation.

Can I exercise again if it no longer hurts?

If the injury was significant or there were vision symptoms, it is better to wait for a medical evaluation before going back to activities with a risk of another impact.

Can a black eye hide an internal injury?

Yes. External appearance alone cannot rule out an injury to the eye or the eye socket, especially if there is pain, double vision or a change in vision.

Conclusion

After a blow to the eye, pay attention to any change in vision, severe pain, blood, flashes, double vision or trouble moving the eye. These signs may point to an injury that needs professional evaluation.

Avoid rubbing or pressing on the area and don't self-medicate. A timely eye exam can identify damage that is not always visible from the outside and set the right treatment.