Make every effort to prevent further injury. Place commercially available protective eye shields on both eyes, or fashion coverings from Styrofoam cups. Tape these protectors loosely to the orbital bones, and do not exert pressure on the globe. Elevate the head of the bed, and instruct the patient not to touch or rub the eye. If nausea or vomiting is present, administer antiemetics and restrict patients to taking nothing by mouth to reduce the likelihood of expulsion of intraocular contents caused by elevated intraocular pressure during vomiting.
Tetanus prophylaxis is indicated.
Initiate broad-spectrum antibiotics, and immediately consult an ophthalmologist. Although empirical and theoretical, recommendations for broad-spectrum antibiotics are universal. In addition, add clindamycin if an intraocular foreign body is present or if vegetable matter has contaminated the wound. The most common organisms identified in posttraumatic endophthalmitis are Staphylococcus epidermidis, bacilli species, streptococci species, gram-negative species, and fungi. Antibiotics - Used in prophylaxis of endophthalmitis.