Applying a pressure dressing to a traumatic eye injury can cause more harm than good

Outline / Skeleton

• Hook: In the crater of a combat zone, quick decisions matter. Eye injuries are delicate, and a pressure dressing seems like a quick fix—but it can cause real harm.

• Why pressure isn’t the answer

• Increased intraocular pressure

• Possible vitreous hemorrhage

• Risk of retinal detachment

• Obstruction of assessment and monitoring

• Practical field actions instead

• Protect, don’t compress: use a light shield or sterile dressing loosely, cover both eyes to reduce movement

• Don’t remove objects embedded in the eye; avoid rubbing or applying pressure

• Keep the patient calm, still, and ready for rapid evacuation

• Manage life-threatening injuries first; treat the eye as a high-priority, but not pressure-based, injury

• What to look for and when to seek urgent care

• Pain, vision changes, bleeding, foreign body sensation

• Signs of more serious damage: double vision, new floaters, uneven pupil size

• Quick recap and real-world takeaways

• The eye is too fragile for a pressure dressing

• Shield, protect, and evacuate

• Early professional care saves vision

• Final thought: Small choices in the field echo later outcomes

Article: When a Pressure Dressings Isn’t the Fix for a Traumatic Eye Injury

You’re in the field, heat, noise, adrenaline—the whole scene is loud enough to mask a whisper. A traumatic eye injury lands in your lap, and your training kicks in fast. It’s tempting to reach for a pressure dressing, the kind that might stop bleeding or feel like you’re giving the eye a snug bandage. But with eye trauma, that instinct can backfire. Here’s the thing: a pressure dressing can do more harm than good, and the consequences aren’t something you want to gamble with.

Why pressure can be dangerous for the eye

Let’s unpack what a pressure dressing does inside and around a damaged eye. The eye is a tiny, exquisite structure. Apply pressure to it, and you’re risking more than a little pinching pain.

• Increased intraocular pressure: Squeezing the eyeball can push more pressure into the eye itself. That extra pressure isn’t harmless; it can worsen injuries inside the eye and complicate healing.

• Vitreous hemorrhage: Pressure can cause or aggravate bleeding into the clear gel that fills the eye. When blood clouds the vitreous, vision becomes fuzzy, and doctors have to untangle a more complex problem.

• Retinal detachment risk: The retina is delicate, and stress on the eye can contribute to detaching layers. Retinal detachment is serious business and may require surgery to restore or preserve vision.

• Obstruction of assessment: A tightly wrapped dressing can hide symptoms or signs that clinicians need to see when they first assess the injury. If you can’t monitor changes, you can’t triage properly.

And there’s more on the practical side: a pressure dressing can actually block your ability to tell how bad the injury is. If you can’t tell whether there’s a growing concern inside the eye, you could miss timing for urgent care. In the field, early recognition matters; anything that hides the truth of the injury can cost vision.

What to do in the field instead of applying pressure

In contrast to the instinct to compress, a smarter move is protection without pressure. Here’s a simple, dependable approach you can carry out without overthinking.

• Protect, don’t squeeze: Use a light, rigid shield or a clean, loose dressing to cover the eye. The goal is to prevent further injury from rubbing or accidental pressure, not to press the eye into submission.

• Keep movement to a minimum: Encourage the patient to stay still. If you can, cover both eyes with a light shield or a clean cup taped around the edges. Reducing motion reduces pain and shields the eye from further trauma.

• Don’t remove embedded objects: If something is stuck in the eye, don’t try to pull it out. Let medical professionals handle it. Removing foreign bodies in the field without proper tools can do more harm.

• Do not rub or squeeze: It can feel instinctive to rub a painful eye, but that’s a fast way to worsen damage.

• If chemical exposure occurred: The response changes. While trauma itself is enough to handle gently, chemical burns require copious irrigation if instructed by the protocol and immediate evacuation. Sloppy irrigation in a field setting without guidance risks washing chemicals further into the eye.

• Stabilize, don’t plaster: If there’s bleeding around the eye, a gentle, loosely placed dressing is enough. You’re stabilizing, not compressing.

• Elevate the situation through evacuation: Eye injuries in the field demand rapid transport to a facility with ophthalmic care. Your job is to keep the patient stable and protect the eye until they get professional evaluation.

A quick guide to red flags in the field

You don’t want to miss something serious. Here are signs that demand urgent medical attention beyond immediate on-site care:

• Severe pain that won’t settle

• Vision changes such as reduced clarity, double vision, or loss of vision

• Blood inside the eye (visible hemorrhage or a “sunken” look)

• Unequal pupil size or an obvious foreign body

• Any penetrating injury or object lodged in the eye

• Signs of trauma to the surrounding head or facial bones that could indicate a broader injury pattern

In these cases, you’re not just protecting the eye; you’re setting someone up for the best possible outcome by ensuring quick, specialized care.

A few field-smart habits that help

• Keep the scene calm: A tense environment makes every little cue harder to read. Talk calmly, reassure the patient, and maintain a steady pace to evacuation.

• Communicate clearly: Tell your team what you’ve found and what you’re doing. Clear handoffs save time and reduce the chance of mistakes.

• Use reliable gear: A rigid eye shield, sterile dressings, and clean saline (where it’s appropriate) are your friends. They help protect rather than pressure.

• Think ahead: If you’re numbering patients or staging the line of evacuation, place eye injuries near the top of the priority list, but don’t neglect other life-threatening injuries. A balanced approach saves more lives.

A real-world frame: why this matters in Tactical Care settings

Pain control, rapid assessment, and safe transport—these threads weave through Tactical Care. An eye is not just a small organ; it’s a gateway to how a person experiences the world. In the field, where conditions change by the minute, the urge to wrap or press is understandable. Yet, the right move is to shield, assess, and evacuate. The consequences of applying pressure aren’t just theoretical. They’re real, tangible risks that can complicate surgery, delay treatment, and, sadly, cost vision.

If you’re curious about how this plays out in real life, think about the rhythm of a medical evacuation: you stabilize, you shield, you transport. You don’t compress and you don’t guess. You rely on trained eyes to decide the next step—literally and figuratively.

Putting the lesson into a simple takeaway

• The eye is delicate. A pressure dressing can push injuries to a worse spot.

• Protect without pressure: shield the eye, keep it calm, and avoid rubbing.

• Evacuate for professional care as soon as possible. Early, precise care preserves vision far better than any makeshift squeeze.

• Watch for red flags that signal more serious damage and require urgent attention.

A gentle closing thought

Eye injuries in high-stakes environments demand careful, precise action. The instinct to secure the area with pressure is natural, but it isn’t the right move for the eye. The best results come from thoughtful protection, gentle handling, and fast access to specialized care. In the end, it’s not about winning a moment of control; it’s about preserving sight for the moments that follow—the moments when a person can see the sunrise again, not just the shadows of a battlefield.

If you find yourself teaching this or applying it, remember: clarity beats haste. A lighter touch, a careful shield, and a clear path to care are exactly what helps someone keep their sight when it matters most. And that’s a win worth aiming for, every time.