What it is
Pediatric eye trauma covers any injury to the eye, eyelid, or orbit (the bony socket around the eye) in children. It ranges from minor — a corneal abrasion from a fingernail, a small foreign body under the lid — to serious — a blunt-force orbital fracture, a ruptured globe, a chemical burn. Any of these can threaten vision, and some of them progress quickly, so it's worth calling us or heading to an ER the same day.
Signs parents notice
- Pain, tearing, or light sensitivity after a blow to the eye or face
- Blurred or lost vision
- A black eye with swelling beyond the bruise
- Bleeding inside the eye (hyphema), or a visibly distorted pupil
- Something that feels stuck or scratchy that doesn't wash out with gentle saline
- Chemical exposure of any kind to the eye — this is an emergency, wash immediately with copious water and call
How we diagnose it
After any significant eye injury we do a careful exam: visual acuity, examination of the front of the eye with a slit lamp, dilated exam of the back of the eye, check of eye movements and pupil response. We may order imaging (CT of the orbits) if an orbital fracture, intraocular foreign body, or globe rupture is suspected.
For higher-acuity trauma we coordinate with the emergency department and, where needed, adult oculoplastic or retina colleagues. Our job is to make sure your child gets to the right person quickly.
How we treat it
Treatment depends on the injury:
- Corneal abrasions — antibiotic drops, sometimes a short patch, follow-up in 24–48 hours
- Superficial foreign bodies — we remove them in the office with topical anesthetic
- Hyphema (blood in the front of the eye) — careful observation with activity restrictions; rarely, surgical drainage
- Orbital fractures — many are managed non-operatively with close follow-up; some need surgery for trapped eye muscles or for cosmesis, coordinated with oculoplastic surgery
- Ruptured globe, intraocular foreign body, severe chemical burn — emergent; we coordinate with the ER and specialty surgery and often these go directly to a referral center
What the journey looks like
Same-day or next-day evaluation is the norm. We follow most trauma patients closely for the first week or two, then at wider intervals as things heal. Kids who've had eye trauma are at slightly higher lifetime risk for things like traumatic cataract, glaucoma, or retinal changes — we keep an eye on those long-term.
When to call us
Call us — or an emergency department if we're closed — right away for:
- Any penetrating injury or suspicion that something went into the eye
- Sudden loss of vision after an injury
- Blood inside the eye (hyphema)
- A distorted or oddly-shaped pupil
- Chemical exposure of any kind
- Significant eyelid laceration, especially near the tear duct area