Eye Trauma

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July 26, 2015
Edward Smith

Eye Trauma

While the eyes are relatively protected by the bones of the face and the placement of the nose, eye injuries can still happen following a motor vehicle accident, altercation, sports injury, or industrial injury.

Injury can happen to the bones around the eye itself, to the orbit (the actual eye), or both. Damage to the eye can result in double vision or loss of vision even if the correct treatment is given. In some cases, eye injuries can be prevented (such as in industrial conditions), while other times, such as in motor vehicle accidents or falls, injury to the eye is unavoidable and must be treated.

Most Common Eye Injury

The most common injury to the eye is an irritation to the outer surface of the eye from a foreign body or scratch. If a foreign body comes in contact with the eye, it can simply scratch the eye or it can become embedded into the eye itself. Metal foreign bodies are particularly dangerous when they scratch the cornea because parts of the metal can leach onto the corneal tissue, causing corneal ulcers and loss of vision. Foreign bodies can go deep into the eye, resulting in an injury that damages the globe of the eye. The eye will become sunken and deflated by the hole created by the foreign body.

The eye can be injured by excessive heat or chemicals that burn the eye. This causes you to close the eye, trapping whatever is irritating the eye and causing further damage. If you are ever exposed to a chemical in the eye, the eye should be immediately flushed with cool water so as to remove as much of the chemical in the eye as possible.

Recognizing an Eye Injury

Eye injuries can be incredibly subtle so that the eye looks normal but a serious injury has occurred. If there is any evidence of an eye injury, an eye doctor or ophthalmologist should be contacted in order to examine the eye with a microscope or other device. You should suspect an eye injury if you find the following signs or symptoms:

  • Pain in the eye
  • Difficulties with vision
  • A laceration of the eyelid
  • A lack of movement of the eye
  • One eye protrudes more than the other
  • The pupil size and shape are not normal
  • There is blood in the iris of the eye that obstructs vision
  • There is blood in the white part of the eye
  • There is a foreign body sensation in the eye

First Aid for Eye Injuries

If an object is stuck in the eye, do not remove it and seek emergency medical attention. Don’t put any drops or ointment into the injured eye unless prescribed by a doctor. An ophthalmologist is a person to see in case of an eye injury although the first person you will likely see is an emergency room physician.

If you have access to a shield, put it over the eye or tape a paper cup over the eye to shield it until medical attention has been received. Never rub or put pressure on an injured eye and don’t take any blood-thinning drugs for the pain, such as aspirin, ibuprofen, or naproxen as this can worsen bleeding within the eye.
If you think a small foreign body is under the lid, gently lift the lid and irrigate the eye with cool water until the foreign body sensation is gone. Scratches of the cornea of the eye can feel exactly like a foreign body in the eye so don’t be surprised when flushing out the “foreign body” does not cure the symptoms. Any chemicals in the eye should be flushed out with large amounts of cool, clean water.

If you have received a blow to the eye in a motor vehicle accident or another injury, you can gently put a cold compress over the eye while seeking medical attention. This can cut down on the pain and swelling of the affected eye. Even mild blows to the eye can be serious and can ultimately affect the vision so seek medical attention, even for mild blows to the eye.

Symptoms of an Eye Injury

The type of symptoms you have with regard to an eye injury depends on what kind of injury you receive. Signs and symptoms of an eye injury that needs medical attention include the following:

  • Any kind of bleeding in or around the eye
  • Blurry vision
  • Dark spots in your vision
  • Double vision
  • Flashes of light in your vision
  • Eye pain—of the globe of the eye or just to the surface of the eye
  • Floaters in the field of vision
  • Excessive tearing of the eye
  • Any type of loss of vision
  • Foreign body sensation in the eye
  • Obvious deflation of the globe of the eye

Diagnosis of an Eye Injury

The ophthalmologist or emergency medicine doctor will need to examine the eye after taking a careful injury as to what happened to the eye. The outer part of the eye will be examined. The doctor will look for step-offs of the bony orbital area, indicating a fracture of the orbital ridge. Double vision while looking up can mean that the inferior orbital ridge has been fractured and entrapment of the muscle that raises the eye has occurred. This needs to be treated with surgery.

The surface of the eye can be seen under a special microscope using fluorescein to light up areas where scratches or foreign bodies are located. Sometimes these scratches or foreign bodies can be seen with the naked eye using a special black light that illuminates the areas that take up the fluorescein dye.

The eye is then dilated so the doctor can look with an ophthalmoscope to see if there is damage to the inside structures of the eye. The doctor will look for damage to the retina or bleeding within the eye itself. Hyphemas, which involve bleeding behind the cornea, can obstruct vision and are seen under the microscope. These can permanently affect vision and must be treated by resting the eye to stop bleeding, allowing the inflammatory cells of the body to get rid of the blood cells that have collected inside the eye.

Treatment of an Eye Injury

Most eye injuries will heal on their own, especially if they involve scratches or lacerations of the surface of the eye. Antibiotic eye drops are used to prevent infection while the eye is repairing itself. Foreign bodies that have metal in them need to be lifted out of the cornea of the eye and all metal leached onto the cornea must be removed.
Foreign bodies that have penetrated the globe need to be removed in sterile conditions in the operating room. In many cases, the eye will heal itself if allowed to seal over and build back any of the fluid inside the eye. In such cases, rest and protection of the eye are all that is necessary.

Lacerations of the eyelids need surgical correction, especially if the delicate cartilage of the eye has been disrupted. If the laceration extends to the eye itself, the lid must be carefully repaired so as to prevent any further disfigurement of the eyelid.

Bruising of the delicate tissue around the eye is common with an eye injury. This can be treated using cold packs, rest, and the avoidance of any type of blood-thinning medication.
If the orbital ridge has been fractured and the muscle, nerve, or blood vessel has become entrapped in the fracture pieces, surgery must be done to repair the fracture and get the entrapped parts of the orbit back into proper position.

Complications of an Eye Injury

Most eye injuries are uncomplicated and normal vision returns in a few days. If there is damage to the lens of the eye or to the retina, permanent vision loss may be expected. Fractures of the orbital ridge also called a blowout fracture, will heal as long as there is nothing entrapped inside the fracture. Rest and cold compresses to the eye will help heal many eye injuries.

Sacramento Personal Injury Lawyer

I’m Ed Smith, a Sacramento Personal Injury lawyer who has handled many eye trauma cases. Our office is a member of the Million Dollar Advocates Forum. Call me anytime for free, friendly advice at 916-921-6400.

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