Lacrimal System Trauma to the Eye
Lacrimal System Trauma to the Eye
Any time there is a penetrating wound to the cornea, the iris is often injured as it is directly beneath the cornea in the eye. The injury can be a direct laceration to the cornea or the iris can prolapse through a laceration in the cornea. Blunt trauma can also impact the iris. The most common injuries to the iris include tears in the sphincter and dialysis of the root of the iris. You can also get iridoschisis and atrophy of the iris. Most iris injuries also result in a traumatic hyphema.
Iris injuries are important because, when they are injured, they result in a distorted, nonreactive pupil and photophobia because the iris doesn’t close down when exposed to light. If the pupil is contracted permanently, there can be a loss of full vision. The idea behind treating an iris injury is to preserve as much of the tissue of the iris as possible and to restore its normal architecture.
I’m Ed Smith, a Sacramento Eye Injury Attorney. Despite recent advances in the treatment of endophthalmitis, infection from penetrating eye trauma continues to present a clinical challenge. It remains an important cause of vision failure following open globe injuries and may complicate seemingly benign injuries such as small, self-sealing corneal lacerations without associated intraocular damage. About 62 percent of all cases of endophthalmitis occur after eye surgery, ten percent are associated with planned or inadvertent filtering blebs and the rest are due to metastatic spread from other infected areas.
Although the prognosis has been significantly improved by recent refinements in diagnoses, antibiotic therapy, and vitreous surgery, the overall prognosis of traumatic endophthalmitis remains poor compared to that seen in intraocular surgery. The reasons for the poor prognosis include associated damage to vital eye structures, infection with extremely virulent organisms, and delay in diagnosis and treatment of the condition. Continue reading ›
Traumatic Optic Neuropathy and Visual System Injury
I’m Ed Smith, a Sacramento Eye Injury Lawyer. Eye lesions aren’t the only cause of impaired vision after trauma to the eye. The optic nerve, optic chiasm, and posterior visual pathways are all vulnerable in patients with open or closed head injuries. The ophthalmologist, focused on the care of the eye, must nevertheless be prepared to recognize and manage retrobulbar lesions.
One of the clinical advantages of ophthalmology is the ability to visualize most of the eye anatomy just by inspecting the globe. Unfortunately, with traumatic optic nerve and chiasmal lesions and abnormalities are apt to be situated beyond the reach of a flashlight, slit lamp, and ophthalmoscope. In cases of neural trauma, the ophthalmologist must be prepared to substitute inference for observation. Some neural lesions are missed because the ophthalmologist has simply failed to appreciate the possibility that the visual sensory pathway has been damaged behind the eye. This means that no assessment of the posttraumatic visual impairment can be considered complete unless the nerve and chiasm have been properly evaluated.
Trauma to the Ocular Motor System
I’m Ed Smith, a Sacramento Eye Injury Attorney. Virtually any form of eye trauma can follow a head injury. Some ocular motor conditions are more common in trauma and various types of injury may be more likely to produce specific types of ophthalmoplegia. This article looks at trauma to the oculomotor system, beginning with the extraocular muscles, followed by a discussion of how injury affects each ocular motor nerve, and the pupillary, trigeminal, and facial nerves.
Eye Examination in the Injured Patient
Taking a history of patients with ophthalmoplegia secondary to injury should include determining the types of forces involved. For example, in a patient with a fourth nerve palsy, the likely site of the primary impact is the region of the opposite forehead. Fractures, especially of the base of the skull or the periorbital areas, should be identified. Shock, coma, or other cause of hypoxia, and the use of narcotic, paralytic, or anti-seizure medications should be noted. It is also important to determine if there have been visual, ocular motor, or neurological problems before the current injury.
On examination, the following observations are important especially in the presence of a complicated ocular motor problem:
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.