Chemical exposure
If your eyes are exposed to a chemical (cleaning solutions or toxic liquids, powders or gases/vapors), flush your eyes with running water for, at minimum, 15 to 20 minutes or until the burning or irritation stops. If you continue to feel discomfort, promptly have your eyes examined for a burn or an abrasion. 

Foreign body and corneal abrasion
Corneal abrasions generally are the result of trauma to the surface of the eye. Common causes include jabbing a finger into an eye, walking into a tree branch or rubbing the eye when grit has settled on its surface. Any object originating outside the body is considered foreign. If there is a foreign body in the eye, be careful not to rub your eye as doing so may scratch the cornea. Have your eye examined to see if there is any obvious foreign body that can be easily removed. If the foreign body is embedded and cannot easily be removed, be sure to request the advice of a physician as soon as possible.

Sometimes you can develop a foreign body sensation with or without a foreign body present. Although the foreign body has already been removed or fallen out on its own, you are left with a corneal abrasion or scratch to the cornea. An examination is necessary and you likely will be start on antibiotic eye drops. Contact lens use should be discontinued until cleared by a doctor.

Open globe
Any injury involving the eye and an object such as a fist or sharp knife should be evaluated for what’s known as an open globe, a medical emergency that could lead to a loss of eyesight. These injuries can be quite obvious, but at times they are not as noticeable, so caution and good evaluation are very important. If there is a large, obvious foreign body lodged in the eye, caution should be taken not to remove the object until a health care provider can assess the injuries. Make sure the eye is secure for the transport to a medical facility to minimize pain or further damage. The eye should be covered with the bottom half of a cutout Styrofoam cup, or similar object, for protection and to prevent further injury.  Be careful to avoid placing any pressure on the eye and don’t use a snug-fitting eye patch. 

Subconjunctival hemorrhage
This is the painless, though alarming, appearance of blood in the white of the eye. It can occur spontaneously or after direct trauma to the eye or activities that increase the pressure in the eyes such as a bout of severe coughing or tightening abdominal muscles from heavy lifting or straining.  You should not experience any vision changes with a subconjunctival hemorrhage. This condition will resolve itself in a week or so without treatment.

Conjunctivitis or Pink Eye
Conjunctivitis can be caused by a variety of agents: bacteria, viruses or as a result of contact with an irritating substance. Conjunctivitis is an inflammation of the conjunctival membrane (or inner eyelid membrane). It’s usually itchy, may be slightly painful and usually involves tearing or yellow, sticky discharge from the eye.  Oftentimes, upon waking up, eyelids will be stuck together due to dried discharge.

If the conjunctivitis is bacterial or viral in nature, be conscious, as the infection is highly contagious. Take great care and use good hand washing technique every time the eye or face is touched. As an example, entire football teams have been stricken with conjunctivitis from improper hand hygiene in the locker room.

Contact conjunctivitis occurs after exposure to a chemical agent or a substance that causes allergy. The conjunctival membrane becomes inflamed, but this type of conjunctivitis is not contagious and usually involves only the affected eye.  For this form of conjunctivitis, the doctor may have you start on a steroid eye drop, but not necessarily antibacterial or antiviral drop.

Hordeolum or a stye
A stye is a commonly occurring infection of the gland at the base of an eyelash. It appears as a red lump, sometimes with a white head like a pimple. Treatment includes warm compresses to the lump and eye drops. It will be painful and warm. On rare occasions, if left untreated, it can develop into a larger infection of the surrounding skin called cellulitis.

Regular eye appointments are extremely important. Don’t wait for an emergency to have your eyes checked. The American Optometric Association recommends that healthy adults between 18 and 60 years old have their eyes checked every two years; those 61 years and older should have their eyes checked every year.

Protect your eyes with regular eye exams, exercise caution and by wear protective safety equipment (glasses, goggles, etc.) when engaging in any activity that could pose risk to your eyes. 

Be good to your eyes and you’ll be rewarded with a lifetime of incredible views.

By Bonnie Paul, RN, BSN. Paul is a senior coordinating nurse with MedAire, the world’s largest integrated maritime provider of medical, travel and security services.  She has provided emergency and remote environment nursing for over 12 years. 

As stated in the body of text, I do not write these articles. They are submitted by various at sea medical health providers and training companies. This article in particular was written by Bonnie Paul, a nurse with MedAire.

It would be my pleasure to contact Ms. Paul and ask her to write a second part of this column on UV radiation, sunlight exposure and senile cataracts. 

We feel that the information in this article is pertinent for all readers as ocular health is important for any and all working at sea as crew.

Thank you for your comments.