Page 240 - PJ MED OPS Handbook 8th Ed

20. Eye Injuries

The basic eye exam should include whether the pupils are reactive or not. Visual acuity in each eye,
extraocular movements, integrity of the eye structures.

The field expedient visual acuity exam should be documented with best performance as reads print,
counts fingers, detects hand motion only, detects light only, no light perception.

For penetrating eye trauma such as shrapnel, do a field expedient vision exam, cover the eye with a
rigid eye shield, provide PO/IV/IM moxifloxacin. If only one is injured do not shield both eyes.

For impaled object, stabilize the object and protect the eye. Give antibiotics.
It is important that you do not put any pressure on the eyeball (Globe). No gauze or soft dressing
should be directly on the eye.

Complicated lacerations of the eyelid should be closed by a specialist.
Refer to the procedure section for lateral canthotomy. The indication is progressive proptosis of the
eye and loss of vision following trauma.

For chemical injuries irrigate the eye continually with water until they get to a specialist or for at
least 30 minutes.

Laser Injuries
The rapid growth of laser technology has resulted in increased use of lasers by DoD, US Allies and
unfriendly forces. This increased use has also increased the risk of laser eye injuries. Military ap-
plications include target designators, range finders and secure communications. Personnel must
ensure proper laser eye protection because of the high susceptibility of the eye to damage. Directed
weapons have the capability to cause ocular hemorrhages, corneal damage through thermal depo-
sition, retinal damage and induced glare and flash blindness.
Signs and Symptoms:
Symptoms vary depending on distance from source, frequency of source, strength of source, length
of exposure and whether any amplifying optics (binoculars, sighting scopes) were used.

Symptoms include:
1. Flash blindness
2. Loss of vision (immediate or delayed)
3. Blurred vision
4. Loss of visual field
5. Eye pain

238 n Pararescue Medical Operations Handbook / 8th Edition