Scenario:
As you're grinding your way up the doubletrack towards Pole Line Pass, a teenager on a
4-runner roars downhill past you, sending a large rock flying into your face. Breaking
your $70 riding glasses, the rock smacks into your eye.
Description:
A blunt hit to the eye can do some real damage. If there's any sign of significant injury
(see below), the eye must be checked.
Concerns:
Blowout. Sudden pressure on the front of the eyeball can push it backwards, "blowing
out" the thin bone between the bottom of the eye socket and the maxillary (cheekbone)
sinus. Deep pain or double vision are suspicious symptoms.
 | This cyclist fell against the stump of a cut-off branch on the Little Cottonwood Creek Trail. It's not just a "black eye." There's deep pain. The CAT scan shows "blowout fracture" of the eye socket (orbit). |
|
Retinal detachment. The retina can be knocked away from the globe of the eyeball. The
detachment can grow over time, eventually blinding the eye. Suspicious symptoms include
flashing lights or a blurred spot in the side of your vision that moves as you move your
eyes.
Hyphema. Small blood vessels around the iris can burst, bleeding into the fluid in the
front of the eye. Symptoms include foggy vision and pinkness or red fluid in the front of
the eye.
Dislocated lens, ruptured eyeball, and other ugly stuff. Even if you have two eyes, when
you lose the vision in one, you've lost a lot.
See the doctor immediately if:
- there's deep pain
- there's any decrease in the sharpness of your vision
- there's double vision
- there's bleeding from the eye
- you see any change in the appearance of the colored part of the eye:
change in shape of pupil
different size pupil compared
to other eye
pink color in the fluid
a dark object floating in the
front of the eye
Bottom line:
Don't take chances with your eye. Unless you're very sure it's just a bruised eyelid, it's
best to go to the ER and have the eye examined.
Corneal Abrasion
Scenario:
As you're riding downhill on Mueller Park, you swing onto the sidewall of the trail as you
pass a pedestrian. A branch brushes your face and there's sharp pain in your eye. It hurts
to blink.
![Except for a little redness, the eye with a corneal abrasion often looks normal. Painful eyes should be checked, regardless of how "normal" they look.](http://cdn1.utahmountainbiking.com/firstaid/images/pics-firstaid/redeye3.jpg "Except for a little redness, the eye with a corneal abrasion often looks normal. Painful eyes should be checked, regardless of how "normal" they look.")
A corneal abrasion is a scratch over the clear part of the eye. It causes an irritable or sharp "foreign body" sensation in the eye. Often it feels like something scratchy is stuck under the upper eyelid, because the eyelid rubs over the scratch as it blinks. With a very minor corneal abrasion, the eye may simply feel "dry." The abrasion usually heals quickly, often overnight. Except for a little redness, the eye with a corneal abrasion often looks normal. Painful eyes should be checked, regardless of how "normal" they look.
Concerns:
A large abrasion may take a long time to heal, and can cause an inflammatory reaction
within the eyeball. Sometimes a sharp object cuts into the deep tissue of the cornea. This
can permanently change your vision. Debris in the scratch, such as shreds of tree bark,
can lead to infection and ulceration of the cornea. There may still be a scratchy particle
stuck under your upper eyelid, and it will continue to damage your cornea. So don't take
chances with your eyeballs. If the scratchy sensation hasn't gone away after you get back
to your car (around an hour), head for the ER.
See the doctor if:
- the scratchy sensation doesn't go away promptly
- vision is blurry
- the eye is sensitive to light
- there is deep pain
- you develop mucous in the eye
Immediate care:
Don't rub the eye. It's best to rest a minute, letting the eye water, with the eyelids as
relaxed as possible. If the symptoms don't go away, turn around and head back.
If something got into your eye (like a bit of dirt from the bike in front of you), and you're far out in the woods and the eye is extremely watery and painful, you can try to dislodge the particle. See the Foreign Body instructions. Make only a single quick attempt to remove the particle. Often it feels like something is still in the eye, but it's the scratch you're feeling.
Scenario:
You're making an early-season run on Ridge 157. On the downhill past the Salamander Flat
fork, the bike in front of you throws a big chunk of mud into your eye. As you put on the
brakes, the eye begins to sting and water.
Foreign material in the eye can scratch the cornea (see corneal abrasion ). There may be an irritable, stinging, or sharp "foreign body" sensation in the eye. Sharp bits of sand or wood can rapidly dig themselves into the tissue of the cornea or underside of the upper lid.
Concerns:
The foreign matter can damage the cornea -- the part of the eye you see through. Debris in
the eye can lead to infection and ulceration of the cornea. A scratchy particle under your
upper eyelid will continue to scratch up your cornea. So don't take chances with your
eyeballs. If the scratchy sensation hasn't gone away after you get back to your car
(around an hour), head for the ER.
- the scratchy sensation doesn't go away quickly
- vision is blurry
- the eye is sensitive to light
- there is deep pain
- you develop mucous in the eye
Immediate care:
Don't rub the eye. (Rubbing the eye can grind loose sharp particles into the cornea!) It's
best to rest a minute, letting the eye water, with the eyelids as relaxed as possible. If
the symptoms don't go away, turn around and head back.
If you're far out in the woods and the eye is extremely watery and painful, you can try to dislodge the particle. Usually it will be under the upper eyelid. Assuming your squirt bottle has clean water in it, flush the eye. Turn your head sideways, so the squirt bottle can aim slightly downward as it faces the eye. With the eyelids gently closed, put your index finger and thumb together and press against the eye, as though you were going to take hold of your eyelids.
While holding gentle pressure, spread the thumb and finger to pull the lids aside. Now squirt for several seconds. If the scratching continues, grasp the upper eyelashes and pull the eyelid straight forward away from the eye. Squirt up into the slit between the eyelid and eyeball. Then rest a minute to see if the symptoms subside.
If you can feel exactly where the particle is, you could try to rub it off. Wash your hands thoroughly. Now pull the eyelid forward, with your thumb on the underside. As the eyelid comes forward, put a free finger (middle finger) against the cleft between the eyelid and eyebrow, then rotate the pad of the thumb so slips under the edge of the eyelid. Run it sideways along the underside of the eyelid where you feel the particle. Be careful about this -- not every doctor would think it's a good idea -- because you're getting germs from your finger into the eye. And (unless you succeed in removing a particle) the more you mess with your eye, the worse it will feel.
If the foreign body sensation persists, leave the eye alone. There may be an abrasion of the cornea, which feels exactly like something scratchy is still in the eye. Go have the eye checked.
Scenario:
Roaring down the pavement of Mill Creek Canyon, you hit a horse fly at 30 m.p.h. Right on
your eye. You blink a couple of times, and make a mental note to wear your sunglasses next
time, but the eye quickly feels back to normal. Back at home, you shower and comb your
hair and... What the hell is that? Staring back at you in the mirror, you see an eyeball
with a huge patch of blood-red over the white part.
A subconjunctival hemorrhage is blood from a burst blood vessel over the surface of the eyeball. Not inside the eyeball itself -- between the tough white globe and the soft clear membrane that covers the globe. It has a frightening appearance, but isn't serious. It takes a couple of weeks to go away.
Concerns:
If there was a significant blow, there could be internal injury to the eye. See the
section on Blunt Trauma.
See the doctor immediately if:
- there's deep pain
- there's any decrease in the sharpness of your vision
- there's double vision
- there's bleeding from the eye
- you see any change in the appearance of the colored part of the eye:
change in shape of pupil
different size pupil compared
to other eye
pink color in the fluid
a dark object floating in the
front of the eye
Immediate care:
Rest. Don't rub the eye. Stay away from smoke, fumes, wind, or dust (or anything else that
makes you blink a lot). Usually, the bleeding is finished by the time you see the redness,
but you don't want to do anything that will restart the bleeding.
Ongoing care:
Expect the patch of blood to spread out over the next two days. It may cover a large part
of the eyeball. The blood will slowly be absorbed by your body. Expect about two weeks.
Avoid any activity that will irritate or bump your eye.
