EYE TRAUMA: TYPES AND CAUSES
Eye Trauma is any injury to the eye that can result in a wide spectrum of tissue lesions of the globe of the eye, optic nerve, and adnexa.
Eye trauma is classified according to the type of open globe injury as, rupture trauma, penetrating trauma, perforating and mixed. And in closed globe injuries such as contusions, lamellar lacerations, superficial foreign body, and mixed.
A penetrating injury or trauma partially cuts or tears a structure of the eye, while a perforating injury completely cuts or tears through a structure. However, both terms are commonly applied to eye trauma that produces defects in the integrity of the eye coats. Specifying the structures involved in the injury is used to properly distinguish between both terms.
Eye Trauma can occur from a foreign body, mechanical injury, and chemical injury.
Foreign body eye trauma occurs when fragments of materials that come in contact with the eye are left unattended during perforating injuries. Examples of a foreign body may include vegetable matter (such as plant materials), glass or plastic materials, iron fillings, wood, sawdust, etc.
Mechanical Injury resulting in eye trauma usually occurs from the direct or indirect impact of external force on the eye. Examples of external force that may cause a mechanical injury include blows (fist punch), collision with objects, wind, etc.
Chemical injury results in eye trauma when strong acids and alkali or other chemical materials cause an irritation on the eye usually in the anterior part of the eye. The severity depends on the nature and strength of the chemical and the duration of contact with the eye. Acid burns are non-progressive and less severe than alkali burns due to the limitation of penetration of chemicals by buffering actions of the tissues. Alkali injuries are usually progressive due to difficulty in neutralizing alkali.
Eye trauma may also occur from surgical complications due to poorly apposed or poorly healed limbal surgical wounds which can result in a variety of postoperative complications. Poorly healed wounds may allow microbial infections.
Signs and Symptoms
Symptoms of eye trauma include swollen eyes, poor vision, a feeling of hotness around the eye, itching, tearing, redness, headache, and mucopurulent discharge.
Signs include hyphema (blood in the eyes), increased eye pressure, redness (bloodshot eyes), excess tearing, reduced vision, blurred vision, blood trapped on the eye surface, etc.
In most cases, the treatment plan is considered depending on the cause of the eye trauma. For chemical trauma, the eye will be flushed thoroughly under running water, followed by a proper assessment of the front surface.
For mechanical trauma, a cold or warm compress may be advised depending on the severity of the trauma. For cases of foreign body, the external surface will be examined to eliminate all fragments of foreign body in the eye.
NSAIDs are advised topically for traumas that present with redness. Antibiotic eye drops can be used with ointments at night. Pressure tests are advised to determine if the eye pressure is high and needs to be lowered.
Overall, management of eye traumas may depend on the cause, severity, duration, and extent of damage done.
It is advised that if you experience eye trauma, immediately consult your eye doctor for care.