Protect the eye after trauma by shielding it rather than applying a pressure dressing.

Eyes in the line of duty: why pressure has no place there

In the heat of a tactical moment, first aid decisions feel urgent. You want to stop bleeding, you want to stabilize the scene, and you want to move someone to safety. But when the injury involves the eye, pressure isn’t the friend you’re looking for. In fact, a pressure dressing should never be used for traumatic eye injuries. It sounds counterintuitive if you’re thinking “bleed = press,” yet the eye is a delicate, high-stakes organ, and pressing on it can make things worse.

Let me explain why this rule matters in real life, not just in a classroom slide.

What a pressure dressing is for (and why it’s tempting)

A pressure dressing is designed to control bleeding and keep a wound clean by applying direct, steady pressure. In many injuries, that’s exactly what you want: a firm seal against bleeding, a stable wound bed, and a bandage that keeps things in place. It’s a handy tool in the field kit, and it’s used widely for limb wounds, head injuries, and other non-ocular traumas where pressure can help.

But the eye isn’t just another wound. The eyeball sits inside the orbit, cushioned by fluid and bones, and it’s connected to delicate nerves and vessels. When pressure is applied to the eye, intraocular pressure can rise. That can push on the retina, damage optic nerves, or worsen a penetrating injury. The result isn’t just more pain—it can mean vision impairment or loss. So yes, the same impulse to press that helps elsewhere can backfire here.

A moment of clarity: the eye and eye protection

In tactical care, protecting the eye means shielding it from further injury while you facilitate evaluation and transport. The goal isn’t to seal off bleeding by squeezing the globe; it’s to prevent rubbing, dust, or secondary trauma, while preserving the eye’s function for the professionals who will treat it.

The right move is simple, but it requires care and a steady hand.

What to do instead: proper management for traumatic eye injuries

1. Stop the eye from being touched or squeezed

• Keep hands off the eye itself. Even gentle rubbing can aggravate a bruised or lacerated eye.

• If there’s blood around the eye, you can lightly cover the area with sterile gauze, but don’t press on the eye.

2. Protect the eye with a shield or cover

• Use a rigid eye shield or a clean, hard cup (a plastic cup can work in a pinch) to protect the eye from dimensional forces or accidental pressure.

• If you don’t have a proper shield, loosely place a sterile dressing over the eye and secure it with lightweight, non-tight tape around the forehead and cheek to hold the shield in place—nothing that presses on the eye itself.

• The key is to immobilize the eye’s movement and shield it from direct contact, not to compress it.

3. Avoid manipulating foreign bodies

• If there’s debris on the eyelid or surrounding skin, you can gently wipe away with a clean gauze, but don’t try to remove any object stuck in the eye. If there is a penetrating injury, don’t attempt to remove it in the field.

4. For chemical exposure, start with irrigation

• If chemical exposure is suspected, immediate and thorough irrigation is critical—flush with clean water or saline for at least 15 to 30 minutes. Do this before applying shields or bandages, and continue to monitor the patient for pain, vision changes, or increasing redness.

• If a contact lens is present, remove it if it’s easy to do so without causing further irritation.

5. Keep the patient calm and upright

• Shock and anxiety can complicate a potential eye injury. A calm approach helps the person maintain stillness and reduces movement that could worsen injury.

• In most field scenarios, keeping the patient upright or slightly seated helps with comfort and airway management.

6. Look for red flags that demand immediate escalation

• Severe pain that won’t ease with basic measures, obvious penetrating injury, vision loss, a globe that looks deformed, or chemical burns that still sting after irrigation are all signals to seek immediate advanced medical care.

• Even if you can’t fully assess in the field, err on the side of caution and arrange rapid transport to a facility with ophthalmology support.

How this plays out in Tier 3-style scenarios

Tier 3 exposure to eye injuries often involves complex environments where you’re juggling security, navigation, and medical care. The overarching aim is to preserve ocular function and avoid causing further harm while you arrange definitive care. In these situations, the emphasis shifts from “stop the bleeding with a tight wrap” to “protect the eye, prevent secondary damage, and get the patient to higher-level care as soon as possible.”

A quick mental checklist you can keep in your kit

• Eye shield or rigid barrier: one piece that won’t press on the eyeball.

• Sterile gauze and lightweight tape: for gentle dressing around the eye or to secure a shield (not to compress the eye).

• Saline or clean water for irrigation: especially critical for chemical injuries.

• Proper lighting and a way to communicate pain and vision changes to teammates or medics.

• Clear instructions for the receiving medical team about what you did and what you observed.

Common misconceptions that can trip you up

• “If there’s bleeding, press it down.” The instinct is understandable, but not for the eye. Bleeding around the eye is a different scenario and needs shielding rather than compression.

• “A cover is enough.” A cover helps, but it must be a shield that doesn’t apply pressure to the eye. A loose dressing wrapped around a shield is fine, but do not press the eye itself.

A word on visibility and field assessments

In the field, you’re often making quick, life-preserving decisions with imperfect information. One of the hardest choices is whether to escalate care or treat on the spot. With eye injuries, the prudent move is to protect first and call for higher-level care sooner rather than later. If you’re in doubt, treat as a potential severe injury and transport promptly. The eye’s function matters in the long run, and you don’t want to gamble with it.

What this means for training and readiness

In training simulations and real-life drills, you’ll see how easy it is to slip into “press to stop the bleeding” reflex. That reflex can collide with ocular safety. The better habit is to rehearse the shield-and-cover approach: shield the eye, avoid pressure, irrigate when indicated, and get to a facility equipped to handle eye injuries. By building this reflex, you reduce a lot of avoidable harm and keep the focus on the bigger mission—protecting life, limb, and vision.

A few final reminders you can carry into any field scenario

• Never apply a pressure dressing to a traumatic eye injury. It’s a hard rule for a good reason.

• Protect the eye with a rigid shield; do not press on the eyeball.

• Avoid unnecessary manipulation of the eye; keep hands off and minimize movement.

• When in doubt, elevate and transport to a facility with ocular specialists.

• Chemical injuries demand immediate irrigation before any dressing.

If you’ve ever watched a team member risk a subtle misstep in eye care, you know how quickly the situation can change. The eye is small but mighty in importance. It’s worth giving it the careful, deliberate attention it deserves.

A closing thought

The next time you’re faced with a traumatic eye injury, picture the eye itself as a delicate, high-value asset—one that deserves protection, not pressure. The rule about pressure is simple, clear, and rooted in the goal of preserving vision. The approach is practical, compassionate, and precise: shield the eye, avoid squeezing, and get professional care on the way. Eyes don’t recover the same way as skin, and in high-stakes environments, treating them with care isn’t just smart—it’s essential.