Avoid placing a shield over the uninjured eye after a traumatic eye injury to reduce psychological stress and preserve balance.

If you’ve ever watched a first-aid drill or been in a tense moment on the ground, you know that tiny decisions can ripple into bigger outcomes. One of those often-overlooked choices is how we shield an eye after a traumatic injury. In Tactical Combat Casualty Care at the Tier 3 level, the instinct to protect can run deep—but when it comes to an eye injury, shielding the uninjured eye is usually the wrong move. The key takeaway: it can cause more psychological distress and complicate the patient’s coordination and perception. Let’s unpack why that matters and what you should do instead.

Should you shield the other eye? Not really. Here’s the thing.

The instinct to cover both eyes is understandable. If you’ve seen a severe eye injury in person or on a training video, you might worry that keeping the eyes exposed leaves the patient vulnerable to further harm or contamination. But in the field, the human eye isn’t just a window to sight—it’s a doorway to balance, orientation, and emotional steadiness. Covering the uninjured eye can trigger a cascade of reactions that go beyond the surface of the wound.

Psychological stress matters a lot more than you might think. When an eye is injured, people already feel exposed, vulnerable, and uncertain about what comes next. Slapping a shield over the uninjured eye can feel like a symbol of worse damage or impending loss of sight. That single impression can spike anxiety, and anxiety isn’t just “in the head.” It affects breathing, heart rate, muscle tension, and even how well a patient can follow simple instructions in a chaotic moment. The more distressed someone is, the harder it is to cooperate with care, which can slow down stabilizing steps and make it harder to get a quick read on the injury.

But there’s more to it than psychology.

Our brains rely on two eyes for depth perception and spatial awareness. When one eye is covered, the world becomes a little more two-dimensional. Even if the injury is not in the non-dominant eye, losing binocular input can mess with balance and orientation—two things you cannot afford to fritter away in a high-stress environment. In a field setting, a patient who can still see with both eyes has a better chance to navigate uneven terrain, identify hazards, and maintain situational awareness. Translation: keeping the uninjured eye open helps preserve a real-time sense of space, which is a practical safety net.

What to do instead: a simple, effective approach

The best practice in the field is to protect the injured eye while letting the uninjured eye stay uncovered. Here’s a practical way to handle it:

• Clean and care for the wound as you can without rubbing or applying pressure to the eyeball.

• Place a sterile eye shield or a rigid, curved shield over the injured eye. The shield should cover the eye to prevent further contact or injury but should not press on the eyeball.

• Leave the uninjured eye uncovered. If you’re using supplies where it’s helpful, you can cap the shield with a soft protective layer around the edges so it doesn’t irritate the surrounding tissues.

• Avoid any direct pressure on the eyeball or surrounding tissues. Do not attempt to remove anything that might be stuck in the eye unless you know exactly what you’re doing and you’re guided by a medical protocol.

• Reassure the patient. A few calm words, steady breathing, and clear instructions can do wonders for anxiety and cooperation.

• Prepare for rapid transfer to higher care. Eye injuries can deteriorate quickly, and prompt medical evaluation is essential.

This approach—protect the injured eye, keep the other eye unblocked—addresses both the physical protection and the psychological well-being of the patient. It’s not just about stopping debris or dampening movement; it’s about preserving the person’s sense of control in a scary moment.

A quick field-checklist you can carry in your head

• Is there visible bleeding or a foreign object? Do not rub. Handle with clean hands and use sterile dressings.

• Is the eye itself exposed or visibly damaged (poking, contact with the surface, or obvious injury)? Use a shield on the injured eye.

• Is the other eye safe and uncovered? Yes? Great—keep it open and give simple, reassuring instructions.

• Any sign of dizziness, confusion, or trouble keeping eyes aligned? That’s a cue to reassess and seek rapid care.

• Are you documenting what you see and the steps you took? Short notes help with later care and handoffs.

Common myths—and why they don’t hold up

Myth 1: Covering both eyes will speed healing because you’re “protecting” everything.

Reality: The body already knows how to heal. Covering the uninjured eye can cause unnecessary stress and disorient the patient, making it harder to stay calm and cooperative.

Myth 2: The more you wrap, the safer the eye is.

Reality: Tight wrapping around the head or over the uninjured eye can actually hinder balance and vision. It can also increase discomfort and anxiety. Light, stable protection of the injured eye is enough for field care until you reach definitive care.

Myth 3: If one eye is hurt badly, both must be handled with the same care.

Reality: No two eyes respond the same way in the moment of trauma. The aim is to minimize further harm to the injured eye while preserving the patient’s ability to see clearly enough to stay oriented and follow commands.

A note on the human element

Trauma care isn’t just about stopping bleeding or protecting tissue. It’s about preserving the person’s dignity, reducing fear, and maintaining a sense of agency in a moment that can feel out of control. The choice to shield only the injured eye is a small, concrete way to support emotional well-being. It’s a reminder that the goal isn’t perfection under pressure; it’s practical, compassionate care that keeps someone steady enough to move toward healing.

Real-world relevance: why this matters in Tier 3 environments

Tier 3 scenarios often unfold under stress, with limited resources and the clock ticking. A decision that seems minor on paper can ripple into improved patient cooperation, smoother handoffs, and a quicker route to definitive care. Keeping the uninjured eye open helps maintain eye-hand coordination, better depth cues, and situational awareness for the trauma responder. It also signals to the patient—and to bystanders—that there’s still control in the moment, which can reduce panic and help maintain a safer, more orderly environment for everyone involved.

Putting it all together: the bottom line

• Do not place an eye shield over the uninjured eye after a traumatic eye injury. The psychological impact can heighten anxiety and complicate the patient’s ability to cope.

• Protect the injured eye with a sterile shield while keeping the other eye open and unencumbered to preserve depth perception and balance.

• Communicate calmly, keep the patient oriented, and hurry toward higher-level care.

If you’re ever in a situation where you’re rendering care, this approach can feel deceptively simple. It’s one of those practical decisions that pays off in real life—where thoughts race, hands move, and every moment counts. The eye is delicate, yes, but with thoughtful care it can be protected without robbing a person of their balance, confidence, or clear sight of the path ahead.

A final reflection

Eye injuries are scary because they touch something so intimate—sight. People fear losing it, even temporarily, and that fear can compound the injury’s impact. By keeping the uninjured eye free from obstruction, you respect the patient’s current state, support their mental steadiness, and keep their navigation through the incident on track. It’s a small shift with meaningful consequences, and it’s the kind of nuance that makes field care more humane and more effective.

If you’re working through these concepts in the field, remember: you’re not just protecting tissue; you’re protecting a sense of safety. And in a setting where every second counts, that sense of safety can be as powerful as any bandage or shield.