A Family Doctor's Tale - EYE INJURIES

DOC I HAVE AN EYE INJURY

EYE INJURY is an traumatic accident to the eye which is a delicate organ and cause permanent loss of vision.

The greatest danger of eye injury comes from sharp objects such as pencils, nails, and knife.
Sharp objects injury to the eye can lead to puncture of the eyeball with extrusion of the eye contents and will require surgery.

Scratches and cuts that damage the cornea and the white of the eye are the most common eye injuries.

Causes of EYE INJURIES can be divided into:
1.Superficial injuries that include corneal scratches and superficial cuts even by the edge of a paper,sand ,or grainy dirt particles.

2.Chemical injuries that occur when liquids such as acids or alkali(bleach, thinner, battery acid) enter the eye

3.Blunt injuries to structures of the eye that give rise to swelling of the eyelid or bruising of the tissues around the eye(examples are sports like basketball, football, boxing or martial arts or home repairs where balls, fists or hammer may hit the eye)

4.Penetrating injuries are serious injuries or cuts in the eye which may result in foreign objects including metal bodies being left in the eye. They require urgent medical attention and surgery.

Symptoms varies from mild to severe:

1.Severe pain in the eye or around the eye

2.burning sensation in the eye especially exposed to chemicals

3.blurred vision

4.Discharge -may be due to eye infection


5.Light sensitivity - sensitive to bright lights

6.bruises around the eyelids or cuts

Signs of injury to surface of or area around the eye:
1.bruising of the eyelid and surrounding area usually due to trauma

2.swelling of the eye or eyelid

3.tenderness of the eye


4.blurred vision

5.redness of the eye

6.feeling of something in the eye

Signs of injury to the inside of the eye:
1.blurred vision

2.seeing floating bodies or flashes of light

3.bleeding into the back of the eye(vitreous hemorrhage)

Diagnosis of EYE INJURIES:
1.Mild cases like chemical splash or small dust particles can be treated by a family doctor

2.More severe cases require an eye specialist to examine the eye with a slit lamp microscope to determine the inside of the eye including the retina and cornea.

3.Movements of the eye and testing of the nerves to eye may be needed.

4.X-rays of the may reveal fractures of the eye socket.

5.Ultrasound of the eye may be needed if there is a lot of bleeding in the eye

6.CAT scan or MRI of the eye may be necessary if a penetrating eye injury is suspected or a foreign body may be present.

The complication is always the risk of :
1.Severe infection of the eye especially with pseudomonas infection causing infection of the anterior chamber of the eye and then spreading to the rest of eye resulting in loss of an eye.

2.Scarring of the EYE INJURY resulting in partial loss of vision

3.metal from foreign body in the eye can cause loss of vision

Treatment depends on the type and extent of EYE INJURY:
A.Superficial injuries can be diagnosed with a stain called fluorescin.
Abrasions and depth of lacerations can be seen clearly with this. They require antibiotics and an eye patch.

Close follow up is needed when there is infection.

B. Chemical injuries require copious flushing of the eye to remove as much chemicals as possible and to minimize damage to the eye. Follow up is necessary to watch up for late complications such as raised eye pressure.

C.Traumatic Injuries to the eye
Bruises to the eye or eyelid -ice packs can be used to reduce swelling during the first 49 hours followed by warm compression to clear the blood

D. Penetrating injuries to the eye :
when there is vitreous hemorrhage or retinal detachment, a surgical procedure called vitreotomy may be necessary to restore vision.
This is a retina surgery where fine instruments are used to remove blood from the the inside of the eye or repair retinal detachment. An air bubble or silicone oil may be injected at the end of procedure to keep the eye in the normal shape.
Vitreotomy may also be necessary in penetrating injuries to remove any foreign body and repair any cuts or laceration inside the eye.
Foreign bodies that are not removed or untreated can result in severe eye infections and blindness.

The prognosis depends on the severity of the eye injury.

Most cases can be restored to normal if treated early.

Some cases may have minimum scarring of the cornea with possible loss of some vision.

Rarely the eye may be lost if there is severe infection and no treatment.

Prevention of Eye Injuries:
1.Take proper safety precautions when dealing with chemicals
and cleaning fluids.

2.Wear goggles when working with sharp instruments or poer tools like drill or saw

3.Avoid rubbing the eyes with hands when handling household cleaning fluids or chemicals of any kind

4. wash the hands thoroughly after handling chemicals or dusts from saws or drills.