June 28, 2018

Injury around the eye

The effects of ocular (eye) trauma depend on the mechanism of injury, and outcomes can range from recovery to irreversible blindness and loss of the eye.

Ocular trauma usually occurs when an object or substance makes con- tact with the eye. When ocular trauma occurs, it can result in blurry vision, complete loss of vision, pain, and physical disfigurement.

Ocular trauma can generally be categorized as blunt, as when a dull object hits the eye, or lacerating, as when a sharp object hits the eye. Blunt trauma is more common and can result from a vari- ety of causes including falls and motor vehicle crashes, including airbag deployment injuries. Lacerating trauma is usually caused by injury with a sharp object like scissors or a variety of workplace- related injuries. Physical assault is a common cause of both blunt and lacerating trauma.

Structures around the eye can also be damaged from blunt trauma. An orbital fracture is when the bones around the eye are broken. This can result in disturbances of eye movement and, if un- treated, can result in double vision and a sunken-in appearance to the eye. Retrobulbar hemorrhage refers to bleeding behind the eye. This is a severe type of orbital hemorrhage that can result in irre- versible vision loss if the pressure from the hemorrhage is not re- lieved emergently.

An open globe occurs when blunt trauma is so severe that the wall of the eye bursts open or when a sharp object pierces the wall of the eye. Open globe injuries are an ocular emergency and are often associated with blurred vision, pain, swelling around the eye, low eye pressure, and irregularities of the iris. When these types of injuries are suspected, it is important not to touch the eye or foreign body and to avoid straining and applying pressure on the eye. Medical care should be sought emergently and surgi- cal repair should occur within 24 hours to prevent an infection and other permanent complications. A shield or even a plastic cup taped over the eye can be used to protect the eye until a medical consultation can be performed.

Seeking Medical Care

Any time ocular trauma results in blurred vision, double vision, pain, and/or light sensitivity, a medical consultation is warranted. In se- vere forms of trauma and when a ruptured globe is known or sus- pected, medical care should be sought emergently.

Author: PradeepPrasad,MD
Conflict of Interest Disclosures: The author has completed and submitted the ICMJE

Preventing Ocular Injuries

Protective eyewear is always recommended when playing sports or engaging in activities (workplace or home projects) in which ob- jects may accidentally hit or fly into the eye. Depending on the ac- tivity, goggles may be the best way to maximize protection.

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