Eye Injury

The 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.


DIRECT BLOW (blunt force)



ARC WELDERS BURNS ("sungazers" 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
balance). Alkali injuries (lye) are worse than acid, due to their greater propensity for deeper destruction. Complete physician eye examination after copious water irrigation (20 minutes or more) is important in determining the extent of damage. The pH of the eye can also be measured to make sure it has returned to normal.

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

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12 Knee Injury Fracture
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12 Abdominal Injury Ruptured Spleen
12 Foot Injury Toe Fracture and Sprain
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Abdominal Injury
Abdominal Injury: Contusion
Animal Bites
Ankle Fracture
Ankle Injury
Ankle Injury: Contusion
Ankle Sprain
Back Injury
Back Injury : Sacrococcygeal Injury
Back Strain
Carbon Monoxide Poisoning
Chemical Burns
Chest Injuries
Chest Injury: Aortic Rupture
Chest Injury: Hemothorax
Chest Injury: Myocardial Contusion
Chest Injury : Pneumothorax
Chest Injury: Pulmonary Contusion
Chronic Back Pain
Clavicle Fracture
Compression Fractures
Decompression Sickness
Disc Disease
Gunshot Wounds
Hand Injury: Fingertip Amputations
Head Injury
Liver Injury
Marine Stings
Muscle Strains
Rib Fracture
Ruptured Spleen
Shoulder Injury: A-C Separation
Spider Bites
Spinal Cord Injury
Sternum Fracture
Testicular Injury
Wrist Injury
hi Scuba Related Injuries
i Hand Injury Finger Amputaion
de Lecerations
de Cold Injury and Hypothermia
dd Dental Injury
xs Facial Injury
sdf Neck Injury
e Shoulder Injury Dislocation
e Ear Injury
ed Elbow Injury
de Elbow Injury Fracture
dfe Elbow Injury Nursemaids
ee Electrical Injury
de Eye Injury
ed Facial Injury General Considerations
fr Facial Injury Contusion
ed Hand Injury Finger Sprains
ded Fingernail and Toenail Injuries
dd Hand Injury Fractures
23 Head Injury Skull Fracture and Concussion
44 Chest Injury Myocardial Contusion
fde Heat Illness
ed Hest Injury Hemothorax
y Back Injury Disc Disease
;l High Altitude Illness

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