My partner revved up the engine of the ambulance. The four of us were ready to head home after 11.5hrs of duty out in the rain. It had been a fairly busy day, lots of minor injuries from lacerations and abrasians to dislocations and fractures, but nothing particularly remarkable. We were pulling out of the parking lot when we noticed several girls behind our vehicle waving us down, one girl had her hand to her eye. I was tired and told the crew in the back that they can take the call, it looked like a sand in the eye call. I was just about to settle back in my seat…
“Hey I think you better take a look at this…she says she can’t see.”
I hopped out of the ambulance and met a girl about my age holding her left eye. She was in a lot of distress.
Me: “What seems to be the problem?”
Patient: “My eye! I can’t see.”
Partner: “She says she’s been hit by a soccer ball.”
I looked at her eyes, one eye was very red and seemed a bit foggy, the other was teary. She was sobbing a bit. It was cold and still drizzling outside, and she was in a T-shirt.
Me: “How about we head into the ambulance and I’ll take a look at your eye for you?”
I got her to sit down as I took my penlight out to inspect her eyes. When I shone the penlight into her injured eye, I was met with a red glow in front of her iris. At first, I didn’t believe what I saw. I blinked. Still, the bright red fluid in her eye glared back at me. I was taken by surprise. I was expecting sand in the eye, not a pool of blood. I don’t recall ever learning about bleeding in the eye in school, but I have seen photos online when I surfed the internet about eye injuries last year. Her eye was exactly the same as those photos, up to half of her eye glimmered with bright red blood under my penlight.
I sounded calm when I called my partner to switch to the major PCR and to do a set of vitals, but inside, my heart skipped an extra beat. This isn’t good. I got an eye patch and started bandaging her eye.
Me: “You have to go to the hospital to get your eye checked out.”
Patient: “What’s wrong with my eye?”
She sounded frightened.
Me: “You got some bleeding in your eye, that’s why you’re having trouble seeing.”
She tried to stiffle a sob.
Me: (Good job, you just scared her to death!) Most of the time the body will reabsorb the blood on its own, but I’m not an eye doctor, so I think it’s best you go get it checked out. (Hmmm…I’m not sure of that was very reassuring…)
We decided to give her a lift to the parking lot, where her friend will drive her to the hospital since we didn’t want her walking (we were on St John Ambulance duty and our ambulance is used as a mobile post, not for transport). We chatted on the ride over and it seemed to calm her down. She reminded me of my friends and when I was a student in university not too long ago. As I said goodbye to her, I wondered how her vision will be, whether she will get her full vision back, what the doctor will say, and what will happen to her exam for school tomorrow.
I guess that’s something I’ll never know.
Some basic information I found on emedicine, paramedic textbook, and some other articles:
Hyphemia is the bleeding in the anterior chamber of the eye, between the cornea and the iris. When blood completely fills the anterior chamber, it is called “eight-ball” hyphema. Hyphema can be caused by blunt trauma (most common), non-trauma (blood clotting problems or cancer), or it can occur spontaneously (rare).
Some signs and symptoms include:
– Blurred vision
– Loss of vision
– Pain when exposed to bright light.
Hyphema is a sight-threatening injury.
In some cases, hyphema can result in permanent, complete, or partial loss of vision. This loss of vision results from complications to hyphema such as glaucoma (increased pressure in the eye), or blood staining the cornea, or from both.
Treatment of hyphema mainly involves resting with the bed slightly elevated. Sometimes eye drops are given to dilate the pupils and reduce inflammation. In severe cases, hospitalization may be needed to monitor the eye pressure. When the body cannot reabsorb the blood, under the discretion of the physician, a needle may be inserted to drain the blood.
Hyphema increases the risk of someone developing glaucoma, so yearly eye examination is recommended for those who have had hyphema.