Eye injury

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

Physical or chemical injuries of the eye can be a serious threat to vision if not treated appropriately and in a timely fashion. The most obvious presentation of ocular (eye) injuries is redness and pain of the affected eyes. This is not, however, universally true, as tiny metallic projectiles may cause neither symptom. Tiny metallic projectiles should be suspected when a patient reports metal on metal contact, such as with hammering a metal surface. Intraocular foreign bodies do not cause pain because of the lack of nerve endings in the vitreous humour and retina that can transmit pain sensations. As such, general or emergency room doctors should refer cases involving the posterior segment of the eye or intraocular foreign bodies to an ophthalmologist. Ideally, ointment would not be used when referring to an ophthalmologist, since it diminishes the ability to carry out a thorough eye examination.

Flying pieces of wood, metal, glass, stone and other material are notorious for causing much of the eye trauma. Blunt injury by fist (during a drunken brawl), ball (cricket ball, lawn tennis ball), shuttle cock (from Badminton) and other high speed flying objects can strike the eye. Small children may indulge in bow-and-arrow games and firecrackers (respectively common during Dussehra and Diwali festivals in India) which can lead to eye trauma. Road traffic accidents (RTAs) with head and facial trauma may also have an eye injury – these are usually severe in nature with multiple lacerations, shards of glasses embedded in tissues, orbital fractures, severehematoma and penetrating open-globe injuries with prolapse of eye contents. Other causes of intraocular trauma may arise from workplace tools or even common household implements. ^[1]

A recent study estimated that from 2002-2003 there were 27,152 injuries in the United States related to the wearing of eyeglasses.^[2] The same study concluded that sports-related injuries due to eyeglasses wear were more common in those under the age of 18 and that fall-related injuries due to eyeglasses wear were more common in those aged 65 or more.^[2] Although eyeglasses-related injuries do occur, prescription eyeglasses and non-prescription sunglasses have been found to “offer measurable protection which results in a lower incidence of severe eye injuries to those wearing them”.^[3]

Multiple complications are known to occur following eye injury: corneal scarring, hyphema, iridodialysis, post-traumaticglaucoma, uveitis cataract, vitreous hemorrhage and retinal detachment. The complications risk is high with retinal tears, penetrating injuries and severe blunt trauma.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

• Closed globe injury or Non-penetrating trauma: The eye globe is intact, but the seven rings of the eye have been classically described as affected by blunt trauma.
• Perforating trauma: The globe integrity is disrupted in one place and may be associated with prolapse of internal contents of the eye.
• Penetrating trauma: The globe integrity is disrupted in two places (through and through injury). This is a quite severe type of eye injury.
• Blowout fracture of the orbit is caused by blunt trauma, classically described for fist or ball injury, leading to fracture of the floor or medial wall of the orbit due to sudden increased pressure on the orbital contents.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

Flying pieces of wood, metal, glass, stone and other material are notorious for causing much of the eye trauma. Blunt injury by fist (during a drunken brawl), ball (cricket ball, lawn tennis ball), shuttle cock (from Badminton) and other high speed flying objects can strike the eye. Small children may indulge in bow-and-arrow games and firecrackers (respectively common during Dussehra and Diwali festivals in India) which can lead to eye trauma. Road traffic accidents (RTAs) with head and facial trauma may also have an eye injury – these are usually severe in nature with multiple lacerations, shards of glasses embedded in tissues, orbital fractures, severe hematoma and penetrating open-globe injuries with prolapse of eye contents. Other causes of intraocular trauma may arise from workplace tools or even common household implements. ^[1]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

A recent study estimated that from 2002-2003 there were 27,152 injuries in the United States related to the wearing of eyeglasses.^[1] The same study concluded that sports-related injuries due to eyeglasses wear were more common in those under the age of 18 and that fall-related injuries due to eyeglasses wear were more common in those aged 65 or more.^[1] Although eyeglasses-related injuries do occur, prescription eyeglasses and non-prescription sunglasses have been found to “offer measurable protection which results in a lower incidence of severe eye injuries to those wearing them”.^[2]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

Multiple complications are known to occur following eye injury: corneal scarring, hyphema, iridodialysis, post-traumatic glaucoma, uveitis cataract, vitreous hemorrhage and retinal detachment. The complications risk is high with retinal tears, penetrating injuries and severe blunt trauma.

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