Eye Trauma

Eye Trauma

Eye Trauma

Eye trauma is an injury to the eye that may result in visual impairment.

Types of eye injuries

  • Corneal Abrasions: A corneal abrasion is a scratch or injury to the cornea, the clear, dome-shaped surface that covers the front of the eye.
  • Chemical burns: Chemical burns occur when your child gets any type of chemical in his or her eye. Chemical burns are a medical emergency, and your child should receive immediate medical care. Chemical burns can result in a loss of vision and even a loss of the eye itself, if not treated promptly and accurately. Household cleaning agents are a common cause of this type of injury.
  • Hyphemia: This refers to blood in the anterior chamber of the eye. The anterior chamber is the front section of the eye’s interior where fluid flows in and out, providing nourishment to the eye and surrounding tissues. A hyphema is usually caused by an injury to the eye, and blood is seen in the eyeball. This is a medical emergency, and immediate medical care is necessary.
  • Bruising or Black Eye (Ecchymosis): Ecchymosis, more commonly known as a “black eye,” usually occurs from some type of injury to the eye, causing the tissue around the eye to become bruised. 
  • Fractures of the orbit: The orbit is the bony structure around the eye. When one or more bones surrounding the eye are broken, the condition is called orbital fracture. An orbital fracture usually occurs after some type of injury or a strike to the face. Depending on where the fracture is located, it can be associated with severe eye injury and damage.
  • Eyelid lacerations: Eyelid lacerations are cuts to the eyelid caused by injury. The physician will examine the eye closely to make sure there is no damage to the eye itself. 
  • Foreign bodies. Click here for more on foreign bodies of the eyes
Corneal abrasion
  • Corneal abrasion is the most common eye injury.
  • They frequently result from eye trauma, retained foreign body, and improper contact lens use
  • It occurs because of a disruption in the integrity of the corneal epithelium or because the corneal surface is scraped away as a result of physical external forces.
  • They usually heal rapidly without a serious sequalae they are often considered of little consequence.
  • However deep corneal involvement may result in facet formation in the epithelium or scar formation in the stoma

Cause of Corneal Abrasion

  • Contact lenses
  • Eyelashes
  • Small foreign bodies eg. Dust , dirt
  • Drying of the eye surface
  • Chemical irritants

Signs and Symptoms of corneal Abrasion

  • Reluctance to open the eye due to Photophobia
  • Tearing
  • Severe eye Pain
  • Reddening of the eye

Management

  1. History taking about;
  • -Any drug allergies
  • -Reoccurrence
  • – past Ophthalmic history.

      2. Record visual acuities in both eyes

      3.  Use the slit lamp or direct ophthalmoscope on high magnification if necessary

      4.  Check for any purulent discharge.

    5. Chloramphenicol eye ointment twice daily to the affect eye for 5days

  • If they are photophobic put I drop of cyclopentolate in the eye
  • Analgesics
Burns to the Eyes (Chemical Burns)
  • The outer surface of the eye may be subjected to burns.
  • Fire burns

Causes

  • Heat
  • Radiations
  • Explosion
  • Hot water
  • Acids (most common cause of burns)
  • Alkaline (also common cause of burns)
  • Ultraviolet rays

Signs and Symptoms

  • Pain
  • Decreased vision
  • Swollen eyelids
  • Reddened conjunctiva
  • Cloudy cornea
  • Cornea ulcers
Penetrating Trauma
  • Perforation of the eyes. These maybe hidden because of the swelling

Causes

  • Glass debris
  • Grinding machines
  • Drilling equipment
  • Chisel
  • Nails
  • Gunshot
  • Arrows
  • Knives

Signs and symptoms

  • Pain
  • Headache
  • Partial or complete loss of vision
  • Bleeding
  • Extrusion of eye content
Blunt Trauma
  • These are injuries caused by blunt objects striking the eye with great force.
  • Common injuries are sports injuries: baseball, tenis, handball, football, boxing and wrestling.

Signs and Symptoms

  • Black eye
  • Eyelid swelling
  • Subcutaneous bleeding
  • Decreased visual acuity.
  • Sub-conjunctival hemorrhage here a well bright area of erythema appears under the conjunctiva

Classification of Eye Trauma.

BETTS Classification

Eyewall- Sclera and Cornea

  1. Closed Globe Injury– No full thickness injury
  2. Open Globe Injury- Full thickness injury

Closed- Globe subgroups

  • Contusion– No full thickness injury (generally a blunt injury)
  • Lamellar laceration- Partial thickness injury of the eye wall (generally a sharp injury)

Open-globe subgroups

  • Rupture– Full-thickness injury of the eyewall by a blunt object
  • Laceration– Full-thickness injury of the eyewall caused by a sharp object

Laceration subgroups

  • Penetrating injury– Single laceration of the eye wall; i.e. no exit wound, if more than one entrance wound then must be from a different agent
  • Intra-ocular foreign body– retained foreign objects causing entrance wounds
  • Perforating injury– two full thickness lacerations with an entrance and exit injury
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