After seeing a bunch of eye injuries in clinic in recent weeks, I was compelled to write this post on eye safety. Let's learn about how we can prevent our kids from injuring their eyes.
How often do eye injuries occur?
The American Academy of Ophthalmology and American Society of Ocular Trauma estimate that every year in the United States more than 2.5 million eye injuries occur, and 50,000 of these folks permanently lose part or all of their vision from these injuries. Approximately half of the injuries occur at home, and 90% of these injuries could have been prevented with protective eyewear!
How many of these eye injuries are in kids?
The most recent study I found that looked at this question was published in JAMA Ophthalmology in 2018. It estimated that there were 1,713,710 emergency department visits for pediatric eye injuries across the United States during a 9-year study period. When this study looked at one year's (2014) worth of emergency room visits for eye injuries in kids, it found that an acute eye injury occurred essentially every 3 minutes for that year.
What are some common causes of eye injuries in kids?
The most common causes of injuries are related to strikes to the eye (such as from play fighting), falls, foreign bodies into the eye (from toys, during home repairs, yard work, cooking), chemical injuries from household cleaners, and from pets. Sports-related eye injuries, especially ball and racquet sports, are also very common as are motor vehicle and gun-related eye injuries.
How can I prevent an eye injury?
FOR AROUND YOUR HOME:
Some of these tips may seem really obvious, but I will list them here anyway since we are still seeing so many eye injuries that occur at home!
1. Childproof your house.
- Use safety gates at the top and bottom of stairs to prevent falls.
- Cushion sharp corners around the house.
- Put locks on all cabinets and drawers that kids can reach to prevent them from having access to objects or chemicals that can be dangerous to them.
2. Practice safe use of common items that can cause serious eye injury.
- While indoors, do not leave your child unsupervised with objects like pencils/pens, paper clips, rubber bands, scissors, bungee cords/ exercise cords, or wire hangers.
- While outdoors, do not leave your child unsupervised with sharp sticks, rocks, or anything that can become a projectile and hit the eye.
3. Keep hazardous chemicals and sprays out of reach.
4. Buy only age appropriate toys.
- Avoid projectile toys like darts, bows and arrows, and missile-firing toys/guns. I cannot tell you how many cases I see every year because a kid accidentally gets hit in the eye with one of these toys!
- Look for toys marked with "ASTM." This means the toy meets the national safety standards set by the American Society for Testing and Materials.
5. Supervise your household pets. Unfortunately, dog bites are a common cause of eye injury in kids, and the culprit dog is usually one the child is familiar with.
- Please do not leave very small children (age 4 and younger) unsupervised with a family pet.
- For older children, it is very important to teach them what is appropriate and inappropriate behavior around a pet.
- Watch for inappropriate behaviors from the child. Intervene if your child climbs on or attempts to ride your dog. Intervene if your child pulls the ears, the tail, lifts the jowls, or otherwise is poking and proding the dog.
- Watch for signs of stress from your pet. If you notice your dog is stiffening, tightening his/her body, moving from panting to holding his/her breath, or growling, you should separate the dog and child immediately. Other signs of stress might include yawning (outside the context of waking up) and lip licking (outside the context of eating food).
- Watch for avoidance behaviors. If your dog moves away from a child, please prevent the child from following the dog.
6. Educate your child on eye safety.
- Teach your child the importance of eye safety when doing yard work and projects around the house.
- Be a good role model for your child and wear protective eyewear when doing work around the house.
- When buying eyewear, look for "ANSI Z87.1" on the lens or frame because this means the eyewear meets the American National Standards Institute (ANSI) Z87.1 safety standard. You can buy these from most hardware stores around the nation and this should be enough for most of the work done around the house.
7. Last but not least, DO NOT allow your child to play with non-powder rifles, pellet guns, BB guns, fireworks, or bottle rockets! Many of these are extremely dangerous for children and can cause serious injuries beyond the eyes.
FOR SPORTS:
As a general rule of thumb, eyewear is recommended for any sport that involves projectiles, balls, sticks/racquets, and close contact. For water sports, skiing, biking, and track and field, which are considered low risk sports for eye injury, eyewear is still also recommended for UV protection. The American Academy of Pediatrics (AAP) and the American Academy of Ophthalmology (AAO) have a joint policy statement that is a great reference if you are curious about the risk of eye injury for your child's sport and want recommendations for the type of eyewear your child should be wearing.
A special note: if your child only has one good-seeing eye, please talk to an eye doctor first before participating in a sport!
FOR THE ROAD:
- It doesn't matter what age you are - everyone should be buckled up while riding in the car!
- Children age 12 and younger should NOT ride in the front seat.
- Most children will not fit well in a seat belt until around age 10 or 11. If your child is not old enough or large enough to use a seat belt, make sure your child is properly secured in a baby carrier or child safety seat and that the seat and shoulder belts fit well.
- Avoid having any loose objects on the floor of your car. These can become dangerous projectiles during a crash.
Don't forget to buckle up whenever you are going for a ride!
What should I do if my child has an eye injury?
- Do not touch, rub, or apply pressure to the eye. This can make the injury worse.
- Do not try to remove any object stuck in the eye on your own. If you notice a small speck on the eye, you can ask your child to blink several times to see if tears will flush this out. If this does not work, do not do attempt to do anything further. Close the eye and seek help immediately.
- Do not apply any ointments or medications to the eye. For most children, applying any medications to the eye can cause a lot of anxiety. This in turn can make an initial eye evaluation very challenging. Ointments can also make visualization of the eye worse. Please do not apply any medications to the eye before seeking help.
- If your child accidentally gets a chemical splash in his/her eye, flush the eye with plenty of water and then seek help immediately.
- If there is a small cut or wound on the eyelid, this can be gently covered with a protective shield. Again, please do not rub or apply pressure to the eye as this can make the injury worse.
- Most importantly, do not delay care! A health care professional should examine your child's eye as soon as possible so that proper treatment can be started. At school, this may be a school nurse or a children's health service that will do the first evaluation. They may then refer you to see your pediatrician, an eye doctor, or direct you to go to the emergency room.
Below are some resources if you want to read more on eye safety. Stay safe!
https://www.aao.org/eye-health/tips-prevention/injuries-protective-eyewear
https://www.aao.org/clinical-statement/protective-eyewear-young-athletes
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2683730