Describe the first aid and the prevention of ocular injury.

First Aid and Primary Care

• Most ocular injuries are first seen by someone who is not an ophthalmologist, and the outcome is frequently decided at that point. A small number of correct actions, and the avoidance of a few wrong ones, matter more than anything done later
• Chemical injury — irrigate immediately, at the scene, with any clean water available, for at least 20 to 30 minutes, holding the lids apart. Do not delay to find saline, to identify the chemical or to telephone for advice. Bring the container
• Suspected open globe — shield, do not pad. Tape a rigid shield (or a paper cup) over the orbital rim so nothing touches the eye; keep the patient upright and nil by mouth; give analgesia and an antiemetic; and do not remove any impaled object

Prevention of Eye Injury

• Ocular trauma IS almost entirely preventable, and prevention is far more cost-effective than any treatment — a point that belongs in the answer because it is the honest conclusion of the subject
• Occupational protection — safety spectacles with side shields for general work; goggles for chemicals and dust; a face shield for grinding and high-velocity work; and a welding shield with the correct filter. polycarbonate is the material of choice, being far more impact-resistant than glass or ordinary plastic
• The obstacles in Indian practice are practical rather than technical — cost, discomfort in heat and humidity, fogging, poor fit, lack of enforcement in the unorganised sector where most workers are employed, and the perception that protection slows work. Addressing comfort and supply does more than exhortation
• Sports — polycarbonate eye protection for cricket, squash, badminton and hockey. Squash and badminton are particularly dangerous because the ball and shuttlecock fit the orbital rim exactly
• The one-eyed patient deserves particular emphasis: anyone with vision in only one eye should wear polycarbonate protection at all times, including for sport and DIY, and should be told so explicitly and repeatedly. This is among the most valuable pieces of advice in ophthalmology and is frequently omitted
• Domestic and paediatric — supervision of children; keeping chemicals, acids and cleaning agents locked away and never decanted into drink bottles; care with sharp toys, bows and arrows, and catapults; and airbag and seat-belt use