Signs of serious eye injuries in children that you should never ignore

Eye injuries in children are one of the most concerning accidents for any parent because the eye is a very sensitive organ, and even a minor blow can turn into a serious problem if not treated promptly. Sometimes the injury may seem minor and insignificant, but in reality, there are specific warning signs that require immediate action and a visit to the doctor before the condition worsens and affects the child’s vision. In this Dalily Medical article, we will explain how to recognize if an eye injury is serious, the key symptoms to watch out for, as well as the diagnostic methods, treatments, and step-by-step first aid procedures.

When should I take my child to the doctor after an eye injury?
You should go immediately if you notice any of the following signs:

Severe swelling or persistent pain.
Continuous tearing or difficulty opening the eye.
Changes in the pupil shape or blurred vision.
Blood or unusual discharge from the eye.

Do all eye injuries affect vision?
Not always. Some injuries are minor and heal easily. But if the blow is strong or affects the cornea or retina, it can lead to vision impairment if not treated quickly.

⚠️ 3. Can a blow to the eye cause blindness?
This is very rare, but in severe cases involving retinal damage or internal bleeding, significant vision loss or blindness may occur. That’s why prompt medical attention is essential.

Can I treat it at home?
You can use cold compresses on the eyelid to reduce swelling if the injury is minor. However, do not apply any eye drops or medications without medical advice. If you’re unsure about the severity, it’s best to see a doctor.
My child can see fine—should I still go to the doctor?
Yes. Internal damage may not be visible at first, and only a doctor can detect it during a proper examination.
Will the eye return to normal after the injury?
In most minor cases, yes, especially with early treatment. Severe injuries may take longer to heal or require surgical intervention to restore vision.
Does the child need rest after the injury?
Yes. It’s best to limit reading or screen time for two to three days, depending on the severity, to help the eye heal faster.

Stages of Eye Injuries in Children

The severity of an eye injury varies based on the force and location of the blow. Injuries often start mild and can worsen over time. Key stages include:

Stage 1: Minor Surface Injury

Occurs from a light bump, such as a ball or toy.
Symptoms: mild redness, slight tearing, minor pain, and slight swelling of the eyelid.
Usually affects only the outer layers like the conjunctiva or eyelid.

Stage 2: Bruising or Subcutaneous Hemorrhage

Happens with a stronger impact.
Symptoms: dark blue or purple bruising around the eye (“black eye”), noticeable swelling, and increased pain.
The eye may appear normal, but internal damage may appear later.

⚠️ 3. Stage 3: Internal Eye Injury

Results from a severe blow, like a fall onto a hard object or a strong hit with a ball or stick.
Symptoms: blurred vision, internal bleeding, severe pain, refusal to open the eye.
Damage may extend to deeper structures such as the cornea, iris, or retina.

Stage 4: Chronic Complications

Occurs if the injury is untreated or extremely severe.
Possible complications: increased intraocular pressure, retinal problems, partial vision loss, corneal opacity, or rare retinal detachment.

Causes of Eye Injuries in Children

Eye injuries are common due to children’s curiosity and activity. Causes include:

Rough play or sudden falls

Children running, jumping, or playing roughly may collide or fall on their face, causing bruises, swelling, redness, or minor eyelid cuts.

Sports injuries

As children get older, sports participation increases the risk. Without protective eyewear, a ball or elbow can hit the eye directly.

Sharp or small toys

Hard or pointed toys (plastic guns, metal cars) may scratch the cornea or cause minor subconjunctival bleeding.

Household accidents

Collisions with doors or tables, falling heavy objects, or misuse of sharp tools can cause eye injuries.

Curiosity and touching the eye

Some children poke or rub their eyes forcefully, leading to scratches or superficial cuts.

Fighting or aggressive play

Pushing, hitting with hands, or using hard objects during conflicts can result in strong blows to the eye.

Types of Eye Injuries and Symptoms

Minor bruises (simple contusions)

Most common type, caused by a light impact.
Symptoms: slight swelling, redness or bluish color around the eye, mild pain.
Treatment: cold compresses and monitoring; usually resolves in a few days.

Subconjunctival hemorrhage

Caused by a burst small blood vessel after the blow.
Symptoms: red spot in the white part of the eye, usually painless and no vision loss.
Treatment: generally resolves in 1–2 weeks, but requires medical check-up.

Corneal scratches or cuts

Occurs with a stronger impact or rough object.
Symptoms: severe pain, excessive tearing, light sensitivity, difficulty opening the eye.
Treatment: antibiotic eye drops, careful monitoring, sometimes protective patching.

Internal eye bleeding (Hyphema)

Severe injury causing blood accumulation inside the eye.
Symptoms: blurred vision, severe pain, change in pupil shape, red color inside the eye.
Treatment: immediate doctor visit, complete rest, specialized care, sometimes surgery.

Retinal detachment or posterior eye injury

Rare but serious, often due to strong trauma or falls.
Symptoms: flashes of light, black spots, partial or complete vision loss.
Treatment: urgent surgery to prevent permanent vision loss.

Orbital bone fractures

Strong blows or falls from heights can break bones around the eye.
Symptoms: severe swelling, deep bruising, difficulty moving the eye, double vision.
Treatment: may require surgery to repair the fracture.

Symptoms to Watch For

Redness of the eye
Swelling of eyelids or surrounding area
Pain or complaints of eye discomfort
Continuous tearing or abnormal discharge
Difficulty opening the eye
Blurred vision or vision loss
Bruising or “black eye”
Internal eye bleeding or red spots on the sclera
Abnormal eye movement or tremors

⚠️ Important: Even mild symptoms require prompt examination by a pediatric ophthalmologist, as some complications may appear later and affect vision.

Diagnosis of Eye Injuries in Children

Rapid and precise diagnosis is crucial to prevent long-term vision problems. Steps include:

Medical history

Time and cause of the injury (ball, hard object, fall, etc.)
Symptoms that appeared afterward, such as pain or blurred vision
Helps the doctor assess severity and plan urgent care

External eye and surrounding area examination

Checks for swelling, bruises, redness
Looks for cuts, visible bleeding
Detects foreign bodies on or around the eyelids

Slit lamp examination

A magnifying device to see fine details of the eye
Detects corneal scratches, conjunctival damage, and subtle internal injuries not visible on a regular exam

4. Visual Acuity Test

This is a fundamental test that helps assess how the child’s vision has been affected after the injury. It indicates whether urgent intervention is needed.

5. Fluorescein Dye Test

Sometimes, the doctor uses a special dye to detect tiny scratches or superficial corneal injuries that are not visible to the naked eye.

Medical Treatment for Eye Injuries in Children

Medication treatment varies depending on the type and severity of the injury. The doctor decides the appropriate medication after diagnosis. Common treatments include:

Anti-inflammatory drops and ointments

Used for swelling or inflammation in the eye or conjunctiva.
Benefits: reduce pain and redness, prevent worsening of inflammation.
⚠️ Sometimes, mild corticosteroid drops are prescribed under strict medical supervision.

Antibiotics (drops or ointments)

Prescribed if there are corneal scratches or superficial wounds to prevent bacterial infection.
Usually used for 5–7 days, depending on the case.

Lubricating drops (artificial tears)

Helps with dryness or irritation caused by the injury.
Benefits: moisturizes the eye, reduces burning sensation, speeds up corneal healing.

Mild pain relievers

If the child experiences noticeable pain, the doctor may prescribe child-safe analgesics (like paracetamol).
⚠️ Do not give any painkiller without medical advice.

Muscle relaxant eye drops (in some cases)

For severe injuries causing eye or eyelid muscle spasms, the doctor may prescribe special drops to improve eye movement and reduce spasms.

Surgical Treatment for Eye Injuries in Children

Surgery is the last resort and is considered when the injury is severe and medication is insufficient. The type of surgery is determined after a full examination.

Eyelid Repair Surgery

If the injury caused a deep cut or tear in the eyelid, precise stitching restores its natural position and function.
The procedure is usually simple, and the child recovers quickly.

Corneal Surgery

For deep scratches or tears that do not respond to medication, the doctor may perform:
- Corneal repair or suturing.
- In very severe cases, a corneal transplant may be required.

Conjunctival Repair or Adhesion Removal

If adhesions or damage occur in the conjunctiva, surgical intervention restores tissue and prevents deformities affecting vision.

Removal of Deep Foreign Bodies

For objects lodged deep in the eye that cannot be removed with simple tools, precise surgical removal is necessary without causing further damage.

Retina or Lens Surgery

For injuries affecting the lens or retina (internal bleeding or detachment), the doctor may perform surgery to repair them and restore vision as much as possible.

Important Post-Surgery Advice for Parents

To ensure proper recovery and optimal results:

Follow the doctor’s instructions completely and use prescribed drops or ointments.
Schedule regular follow-ups to monitor vision improvement.
Prevent the child from rubbing or touching the eye, especially during the first weeks after surgery.

First Aid for Eye Injuries in Children

Eye injuries in children must be taken very seriously, as delays or wrong actions can lead to serious complications. If a child suffers an eye injury at home or during play, follow these steps calmly and quickly:

Stay calm and comfort the child

Keep your composure and reassure the child to prevent stress or rubbing of the eye.

Use cold compresses for swelling ❄️

For minor bruises or swelling around the eye, apply a cold pack or a clean damp cloth for 10–15 minutes.
Avoid direct pressure on the eye.

Do not press or rub the eye ✋

Never press the eye or allow the child to rub it, as this can worsen internal damage.

Do not attempt to remove foreign objects yourself

If visible sand or dirt is present, rinse gently with clean water.
Do not insert fingers or tools into the eye.

Cover the eye if the injury is severe

If the child cannot open the eye or there is blood or a deep wound, cover it with a clean gauze pad without applying pressure.

Seek immediate medical attention

Even if the eye looks normal, it must be examined as internal injuries may not be visible.

Important Tips:

Do not use drops or medications without medical guidance.
Do not attempt to treat the wound at home.
Allow the child to rest and avoid rough play until the doctor confirms recovery.