(10) If the patient is unconscious, close his eyes as much as possible before
bandaging to keep eye tissues from drying. (Blindness can be caused by drying
tissues.) Closed eyes allows moisture from normal tears to keep tissues moist.
(11) Keep the patient at rest in the supine position with his upper torso
elevated fifteen to thirty degrees.
(12) Evacuate the patient.
ENUCLEATION/EYEBALL KNOCKED OUT OF SOCKET
Enucleation is the complete surgical removal of the eyeball. Enucleation could
also be the eyeball being knocked completely out of the socket so that the eyeball does
not rupture. The eyeball will rarely be knocked completely out of the socket. Follow this
procedure for an eyeball being knocked partially out of the socket:
a. DO NOT try to put the eye back in the socket.
b. Cover the eye with a moist covering and a protective cup. DO NOT apply
pressure to the eye.
c. Apply a bandage compress or roller bandage to cover both eyes.
d. Position the patient with his face up.
e. Evacuate the patient to a medical treatment facility.
a. Lacerated or Partially Torn Eyelid(s). Return the eyelids to their normal
anatomic position. Cover the injured lid(s) completely with a moist dressing. Make the
dressing snug enough to hold any pieces of skin in place. Patch both eyes, reassure
the patient, and evacuate him to a medical treatment facility.
b. Completed Separation of Eyelid(s).
(1) Eyelid separated--half eyelid. Recover eyelid(s) fragment(s) and put the
pieces in the normal anatomic position as much as possible. Lower the lid(s) which was
separated. Pull the upper lid down to cover the eye and tape the lid in place. Cover the
injured area with moist gauze and evacuate the patient to a medical treatment facility.
(2) Eyelid separated--eyelid lost. If the upper eyelid is lost, cover the
eyeball with ophthalmic ointment. Examine the eyeball to be sure there is no
penetrating injury. Then, patch both eyes. Reassure the patient and evacuate him to a
medical treatment facility. If evacuation cannot be accomplished in twenty-four hours
for either eyelid injury, consider giving the patient antibiotics.