Ocular Injuries: Evidence-Based Strategies for Urgent Care Management (Trauma CME)

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Publication Date: July 2025 (Volume 4, Number 7)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 07/01/2028.

Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 3 Trauma CME credits, subject to your state and institutional approval.

Update Contributor

Peer Reviewer

Abstract

Patients with ocular injuries are commonly seen in the urgent care clinic, and these injuries are the most frequent cause of noncongenital monocular blindness in children and adults. Systematic evaluation and management will ensure that they have the best chance for a favorable final visual outcome. This review provides evidence-based recommendations for the diagnosis, treatment, and disposition of patients with common ocular injuries presenting in the urgent care setting, as well as an overview of more serious injuries that occasionally present to the urgent care that require specialist or emergency department referral.

Case Presentations

A 32-year-old woman presents to urgent care after an unknown chemical splashed into her left eye at work…

• She immediately began irrigation but continues to complain of pain and decreased vision in the eye.
• After a quick gross examination and pH testing, you administered tetracaine eye drops to the affected eye and initiated immediate irrigation with lactated Ringer’s solution and a commercially available irrigation scleral lens device.
• After 30 minutes of irrigation, the patient feels better. The pH of her eye is 7.4.
• You wonder if you should refer this patient to an ophthalmologist…

A 24-year-old man presents to urgent care with a foreign body sensation of his right eye. This occurred while he was grinding metal in his garage at home yesterday…

• He was wearing eye protection while doing the grinding but did remove his glasses at times and notes that “metal dust was everywhere.”
• He complains of a foreign body sensation and eye irritation.
• He has no significant eye problems and does not wear glasses or contact lenses.
• Gross eye examination shows mild conjunctival injection but is otherwise normal and no abrasion or foreign body is seen. Visual acuity of 20/30 OD, 20/20 OS, and 20/20 OU.
• As you are about to write a prescription for erythromycin eye ointment, the patient asks, "Are you going to put that yellow stuff in my eye like they did last time this happened?”

A 63-year-old woman presents to urgent care with eye discomfort after she was pruning plants in her yard…

• She says she feels like something is in her eye and states, "It’s really irritating."
• Her eye is watering, and she feels like her vision is blurry. Symptoms continued even after she removed her contact lenses an hour ago.
• She was not wearing glasses or any eye protection while gardening but did not specifically get the sense that something went into her eye at any time.
• She complains of moderate pain and light sensitivity in addition to the sense of something in her eye.
• You wonder if this is a simple case of foreign body with corneal abrasion...

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.