TRAUMA

Eye trauma can be divided into blunt and sharp injuries. These injuries can range from a small foreign object on the eye's surface to complex injuries that often require challenging eye surgery. Although some of these injuries can be managed medically, many will require surgical intervention.

Any direct injury or blow to the eye can cause severe damage and, in some instances, depending on the nature of the trauma, lead to permanent blindness. Certain eye conditions such as high intraocular (eye) pressure and retinal detachment are less apparent than bleeding from the eye. Bleeding from the eyes due to burst blood vessels is typically harmless, but bleeding from the pupils and iris specifically is a condition called hyphema and is much more serious.

Causes

Playing intense sport or sustaining an injury to the face can lead to eye trauma and bleeding. Other less prevalent causes of bleeding from the iris or pupil are:

• Eye cancer
• Eye infections due to the Herpes virus
• The inability of blood to clot
• Issues with the new intraocular lenses after cataract surgery

Procedures related to eye trauma

Documenting ocular trauma for clinical purposes or in case the patient wishes to take legal action is essential.

Ophthalmologists consider these questions:

• Was the injury of high velocity?
• Is there any penetration from a foreign body?
• What is the nature of the trauma? Is it a result of drugs, a motor vehicle accident or an assault?

Before surgery, doctors perform a visual acuity test to assess a patient's light perception, which is crucial for prognosis. The next step is to determine the extent of the eye injury, including the structures affected and the damaged layers. By use of a slit lamp, an eight-point ophthalmic evaluation can be done to assess the eye lens, iris and presence of vitreous fluid.

Diagnostic procedures of traumatic eye injuries include:

• Concern over what caused the cornea to lacerate is confirmed by means of a CT scan. Other than this, bleeding obscures the globe, and the extent of the damage may be unclear. A CT scan is carried out to assess the severity of the injury.
• A fundoscopy is an examination of the eye’s inner lining at its rear end (eye-fundus). It provides an overall view of the retina—an eye exam of this nature detail retinal swelling, white clouding and potential bleeding. Apart from bleeding and clouding over the eye lens, a fundoscopy detects brain disorders, glaucoma, macular degeneration and retinal detachment.

In case of internal damage, should the contents of the intraocular cavity leak from the inside out, repairing the damage needs to be made a priority. The first step is to seal the leaky globe and then wait a few more weeks until the inside heals completely. A second operation can only happen ten days after the inside rejuvenates or an infection clears up.