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Eye InjuryThe eye is a complex structure. A simple introduction to the general anatomy of the eye will be necessary. Here are some of the major components of the eye that are susceptible to injury. 1. CORNEA - This is a clear tough outer coating over the pupil. 2. RETINA - This is a thin layer of light (and color) sensitive cells (rods and cones) which line the back of the eye, sending information to the brain, that leads to the production of an image. 3. CONJUNCTIVA - This is a thin outer membrane which coats the "white" of the eye and the inside surface of the lids. TYPES OF EYE INJURY
ABRASIONS and FOREIGN OBJECTS CHEMICAL INJURY ARC WELDERS BURNS ("sungazers" injury) PENETRATING INJURY A DIRECT BLOW via a blunt instrument or fist can result in bleeding into the eye, detachment or tears to the retina, or fractures in the bones around the eye. Hyphema refers to bleeding in the clear space just in front of the pupil [under the cornea]. The eye takes on a dark "8 ball" appearance and the patient experiences a marked decline in visual acuity. This problem is a ophthalmological EMERGENCY. Hyphema can be difficult to treat and bleeding can be recurrent. Permanent staining of the cornea can also occur; this is associated with permanent visual impairment. Blunt force to the eye can also result in deeper bleeding within the eye (vitreous hemorrhage). In this case, bleeding usually clears in time, with no permanent impairment. The patient will also experience "blurry" vision. Retinal tears or detachments may be perceiveds "flashing lights" or loss of vision to a peripheral field. One of the most common eye injuries is the subconjunctival hematoma. In this case, the "white" of the eye takes on a dark red appearance secondary to rupture of blood vessels within the conjunctiva. This injury may take several weeks to resolve and, in most cases, will clear without any long term disability or special care.REMEMBER, any trauma to the eye resulting in ANY visual impairment warrants IMMEDIATE medical attention. Referral to an ophthalmologist may be necessary. ABRASIONS or "scratches" can occur to the cornea and the conjunctiva via sand, grit, metal, foreign objects, or a "poke to the eye." Abrasions to the cornea or conjunctiva can be detected by the physician during a slit lamp examination. This is a modified microscope that allows the doctor to see subtle irregularities in the corneal surface. Foreign objects or debris can also be found and removed. These injuries are quite painful and usually increase in severity over the first 12 hours after injury. The feeling that "something is in my eye" is a well recognized hallmark of this injury. After close examination, the eye will be patched closed with an antibiotic ointment (ordrop), and often a medication to dilate the pupil is applied. Pain medications may be necessary, but rarely used for more than 36 hours. Healing is generally complete 36 to 48 hours later. Any injury with the potential to leave objectsmbedded in the eye (e.g. metal flecks) should have x-rays taken to rule out any deep FOREIGN OBJECT within the eye. Follow-up with an ophthalmologist is important. CHEMICAL INJURIES via bleach, chlorine, or acid are uniformly treated with rapid and copious amounts of water to irrigate the eye. Depending on the type of exposure, irrigation should continue for 15-30 minutes. This treatment clears the offending agent from the eye, restoring normal pH (acid/base ARC WELDERS BURNS are corneal burns caused by ultraviolet light. This is similar to the injury caused by "snow-blindness." Ultraviolet light is damaging to the cornea and subsequent pain, 8 to 12 hours later, indicates a burn. After examination an antibiotic ointment and medications to dilate the pupil will be applied. Eye patching will be necessary so the eye cannot open under the patch. Healing is generally complete in 48 hours, depending on the severity of the burn. See a physician IMMEDIATELY for this problem. PENETRATING EYE INJURIES such as those caused by a knife or BB gun require IMMEDIATE medical attention. The extent of permanent injury will be based on involvement of the optic nerve, or rupture to the eye itself. (Super-glue) eye injury can be found in the POISON FILE. ALL THE ABOVE INJURIES REQUIRE IMMEDIATE PHYSICIAN EVALUATION
|  Hip Dislocation Hip Fracture Insect Stings and Spider Bites Human and Animal Bites Shoulder Injury Fracture Toxic Inhalations and Carbon Monoxide Poisoning Facial Injury Jaw Fracture and Dislocation Kidney Injury Knee Injury General Considerations Knee Injury Contusion Knee Injury Fracture Knee Injury Sprain Stab Wounds Leg Injury Fractures and Contusions Leg Injury Shin Splints Lightning Injury Oral and Tongue Injuries Nasal Fracture or Contusion Neck Injury General Considerations Neck Injury Fracture Neck Injury Spinal Cord Injury Pelvic Bone Fracture Puncture Wounds Chest Injury Rib Fracture Back Injury Sacrococcygeal Injury Scorpion Bites Abrasion Injuries Shoulder Injury Clavicle Fracture Shoulder Injury Strains and Sprains Snakebite Neck Injury Spinal Cord Injury Abdominal Injury Ruptured Spleen Foot Injury Toe Fracture and Sprain Vaginal or Vulvar Injury Drowning and Near Drowning |
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