Eye injury overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Saumya Easaw, M.B.B.S.[2]

## Overview

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Physical or chemical injuries of the eye can be a serious threat to vision if not treated appropriately and in a timely fashion. The most obvious presentation of ocular (eye) injuries is redness and pain of the affected eyes. This is not, however, universally true, as tiny metallic projectiles may cause neither symptom. Tiny metallic projectiles should be suspected when a patient reports metal on metal contact, such as with hammering a metal surface. Intraocular foreign bodies do not cause pain because of the lack of nerve endings in the vitreous humour and retina that can transmit pain sensations. As such, general or emergency room doctors should refer cases involving the posterior segment of the eye or intraocular foreign bodies to an ophthalmologist. Ideally, ointment would not be used when referring to an ophthalmologist, since it diminishes the ability to carry out a thorough eye examination.

## Causes

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Flying pieces of wood, metal, glass, stone and other material are notorious for causing much of the eye trauma. Blunt injury by fist (during a drunken brawl), ball (cricket ball, lawn tennis ball), shuttle cock (from Badminton) and other high speed flying objects can strike the eye. Small children may indulge in bow-and-arrow games and firecrackers (respectively common during Dussehra and Diwali festivals in India) which can lead to eye trauma. Road traffic accidents (RTAs) with head and facial trauma may also have an eye injury - these are usually severe in nature with multiple lacerations, shards of glasses embedded in tissues, orbital fractures, severehematoma and penetrating open-globe injuries with prolapse of eye contents. Other causes of intraocular trauma may arise from workplace tools or even common household implements. [1]

## Epidemiology and Demographics

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A recent study estimated that from 2002-2003 there were 27,152 injuries in the United States related to the wearing of eyeglasses.[2] The same study concluded that sports-related injuries due to eyeglasses wear were more common in those under the age of 18 and that fall-related injuries due to eyeglasses wear were more common in those aged 65 or more.[2] Although eyeglasses-related injuries do occur, prescription eyeglasses and non-prescription sunglasses have been found to "offer measurable protection which results in a lower incidence of severe eye injuries to those wearing them".[3]

## Natural History, Complications and Prognosis

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Multiple complications are known to occur following eye injury: corneal scarring, hyphema, iridodialysis, post-traumaticglaucoma, uveitis cataract, vitreous hemorrhage and retinal detachment. The complications risk is high with retinal tears, penetrating injuries and severe blunt trauma.

## References

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1. ↑ Feist RM, Lim JI, Joondeph BC, Pflugfelder SC, Mieler WF, Ticho BH, Resnick K. "Penetrating ocular injury from contaminated eating utensils." Archives of Ophthalmology. 1991 Jan;109(1):23-30. PMID 1987951.
2. ↑ 2.0 2.1 Sinclair SA, Smith GA, Xiang H. "Eyeglasses-related injuries treated in U.S. emergency departments in 2002-2003." Ophthalmic Epidemiol. 2006 Feb;13(1):23-30. PMID 16510343.
3. ↑ May DR, Kuhn FP, Morris RE, Witherspoon CD, Danis RP, Matthews GP, Mann L. "The epidemiology of serious eye injuries from the United States Eye Injury Registry."Graefes Arch Clin Exp Ophthalmol.2000 Feb;238(2):153-7. PMID 10766285.

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