Common Eye and Ear Injuries

Key Takeaways – Major Eye and Ear Injuries & First Aid

• Major eye injuries from blunt trauma (e.g., sports, accidents, workplace hazards) can cause bleeding, vision loss, and severe pain — seek urgent medical help.

• Follow DRS ABCD first aid steps: call 000, keep the injured eye closed, apply a sterile eye pad, and monitor until professionals arrive.

• Minor eye injuries (sand, dust, metal particles) require gentle removal with a damp cloth, saline flush, or sterile dressing if the object remains.

• Avoid rubbing the eye, using unsterile tools, or delaying treatment for foreign bodies in the eye to prevent infection and long-term damage.

• Ear injuries may be caused by foreign objects, insects, loud noise exposure, water entry, or blunt force trauma.

• Do not insert cotton buds or sharp objects into the ear canal; improper cleaning can lead to eardrum rupture and infection.

• Ruptured eardrum symptoms include hearing loss, ringing, vertigo, and fluid drainage — keep the ear clean, avoid liquids inside, and seek urgent care.

• Prevent ear damage by using ear protection in noisy environments, drying ears after swimming, and wearing protective gear during contact sports.

• Untreated eye or ear injuries can result in permanent vision or hearing loss, infections, tinnitus, and chronic pain.

• Early first aid combined with prompt medical attention is essential for protecting long-term eye and ear health.

Major Eye Injuries – Blunt Trauma to the Eye

The eye is susceptible to direct knocks, e.g., sporting balls, fistfights, finger pokes, traffic accidents, workplace tools, etc. These injuries are characterised by blood in the eye, penetrating objects, vision disturbance, protrusion of eye contents, and severe pain and spasms. Also, the casualty may see ‘black’ in their vision, which moves when the eye moves. In this case, casualty care is critical and should be left to the experts.

First Aid Treatment

• Follow DRS ABCD – Call 000
• Rest casualty in a semi-sitting position and reassure
• Ask the casualty to keep the injured eye closed
• Place a cool, damp cloth onto the wounded eye
• Cover the injured eye with a sterile eye pad and gently secure it into place using a bandage or hypoallergenic tape.
• Monitor casualty until the arrival of medical personnel.
  

Minor Eye Injuries – Foreign Body in the Eye

Flicking sand, sawdust, flying slivers of wood, metal particles, glass shards, stone, grit, and other materials are notorious for causing eye injuries when projected into the eye. It is characterised by a bloodshot eye, irritation, and an urge to rub the eye.

• Follow DRS ABCD
• Use a clean, wet cloth to remove any particles from the area surrounding the eye.
• If the small foreign object is visible, use a damp cotton swab to remove
• If not removed, flush the eye with a steady, constant stream using saline or clean water. Tilt the casualty’s head while gently pulling the eyelid as you flush the eye
• If the lodged object can’t be removed, cover the injured eye with a sterile eye pad and gently secure it into place using a bandage or hypoallergenic tape
• Seek medical attention

Foreign Body in the Ear

The skin in the ear canal and the eardrum is susceptible. Any inflammation or injury is usually readily apparent due to pain or irritation.

Most objects that get stuck in the ear canal are placed there by the person. Children who are curious about their bodies and interesting objects (children aged 9 months to 8 years) most often have this problem.

Insects can also fly or crawl into the ear canal. This usually happens while sleeping on the floor or outdoors (for example, camping). It is often a frightening and dramatic event, as the insect’s buzzing and movement are very loud and sometimes painful.

• If the item is tiny, have the casualty lie on their side, ear facing down. Gently pull the back of the ear toward the back of the head (straightening the ear canal). With gravity to help, the object may fall or roll out.
• If an insect, shine a bright light into the ear to encourage the insect to escape. If unsuccessful, lay the casualty on their side, ear facing up, and drizzle clean vegetable or baby oil into the ear. Allow to settle for 15 sec, then tip the oil out. Insects will often come out with the oil. If you suspect that the insect is dead, you may be able to flush it out of the ear using warm water and a syringe (without the needle).

Note:

• Do not strike the head on the opposite side to try to dislodge the stuck item
• Do not use any items such as tweezers or cotton buds to probe into the ear. Seek medical attention immediately when:
• The Casualty has the following symptoms: The ear is swollen (inflamed), red and displaced outward, fever, discharge, bleeding, or increasing pain
• If the object in the ear is a battery
• You were unsuccessful in removing the object/insect

How to Prevent Ear Injury and Ear Bleeding?

Ear injuries can occur in various forms, from accidents to loud noises to improper ear care. Preventing ear injury is essential to maintaining healthy hearing and avoiding long-term complications. 

Avoid Exposure to Loud Noises

Loud noises are one of the leading causes of ear damage. Prolonged exposure to sounds over 85 decibels (dB) can damage the delicate structures of the inner ear. To protect your hearing:

• Wear ear protection: Use earplugs or earmuffs when attending loud events like concerts or working in noisy environments.
• Limit loud music exposure: If you’re listening to music with headphones or earphones, keep the volume at a moderate level and take breaks to give it a rest.
• Keep a safe distance: Limit exposure to extremely loud sources like fireworks, chainsaws, or heavy machinery.

Use Proper Ear Care Techniques

When cleaning the ears, avoid inserting cotton swabs or other objects into the ear canal. These can push wax deeper or even puncture the eardrum. 

Protect Your Ears While Swimming

Water can sometimes get trapped in the ear, causing discomfort and infection. If you swim frequently:

• Use earplugs: These help prevent water from entering the ear canal.
• Dry your ears after swimming: Tilt your head to each side to allow excess water to drain out, and use a towel to gently dry the outer ear.

Be Cautious During Sports and Physical Activities

Certain sports, especially contact sports like football, boxing, or rugby, can lead to ear injuries. Wearing protective headgear or ear protection during these activities can reduce the risk of ear traumas.

Watch for Changes in Air Pressure

Changes in air pressure during flights or diving can lead to ear barotrauma, which can cause pain and discomfort. To help equalise pressure:

• Swallow or yawn frequently during takeoff and landing.
• Use earplugs designed for flying to help maintain pressure balance.

Ruptured Eardrum

Signs and Symptoms

• Hearing loss
• Ringing sound in the ear (tinnitus)
• Loss of balance, spinning sensation (vertigo)
• Watery, bloody, or pus-filled fluids draining from the ear
• Severe pain

First Aid Treatment

• Place sterile cotton gently in the outer ear canal to keep the inside of the ear clean.
• Assist the casualty into a position of most comfort, with their injured ear tilted towards the ground.
• Get urgent medical help.
  Note:
• Do not block any drainage coming from the ear
• Do not put any liquid into the ear
• Do not try to clean or wash the inside of the ear canal.

Cuts on the outer ear

Apply direct pressure until the bleeding stops.

• Cover the injury with a sterile dressing shaped to the contour of the ear and tape it loosely in place
• Apply cold compresses over the dressing to reduce pain and swelling
• If part of the ear has been cut off, keep the part. Get medical help right away
• Refer to Module 5.2 on how to manage the amputated part

Possible Complications of Ear Injury and Bleeding

Ignoring ear injuries and ear bleeding can lead to several serious complications that may impact your hearing and overall ear health. 

Hearing Loss

If an ear injury or bleeding is left untreated, it can lead to permanent hearing loss. This is especially true if the eardrum has already ruptured, if the injury damages the inner ear structures, or if infections go unaddressed.

Ear Infections

Untreated ear injuries or bleeding can introduce bacteria into the ear canal, leading to otitis media (middle ear infection) or otitis externa (outer ear infection, commonly known as swimmer’s ear). Infections can worsen over time, resulting in complications such as a ruptured eardrum or spreading to nearby tissues.

Tinnitus

Tinnitus– ringing in the ears, can result from acute and chronic ear injuries. It can be a distressing symptom that might worsen if the underlying injury isn’t treated promptly.

Chronic Pain and Discomfort

An untreated ear injury may lead to ongoing pain, drainage, or fullness in the ear. This can be uncomfortable and interfere with daily activities, affecting sleep, work, and overall quality of life.

Damage to the Eardrum

Damage can persist to an untreated ruptured eardrum. It may lead to chronic problems such as hearing loss or persistent fluid buildup in the middle ear.

Care and Treatment for Ear Injuries, Infections, and  Bleeding

Reducing the risk of ear infections and ruptured eardrums involves protecting the ears from external damage, keeping them clean and dry, and seeking timely treatment for any issues.

1. Keep your ears clean and dry.
2. Prevent allergies and sinus issues.
3. Avoid exposure to smoke and irritants.
4. Wash your hands regularly.
5. Use ear protection.
6. Treat respiratory infections early.

Conclusion

Eye and ear injuries can range from minor discomfort to severe conditions. Taking a first aid course to provide quick first aid can help manage symptoms, but seeking medical attention is crucial for severe injuries. Preventive measures like wearing protective gear and avoiding loud noises can reduce risks. Timely care is essential for protecting long-term eye and ear health.