What Are Different Types of Eye Injuries?

The injuries of mechanical eye trauma vary in shape and attributes. Such ocular injuries include blunt contusion, perforation injury, rupture injury, and foreign body injury. The severity of the injury is related to the injury's movement style, speed, and direction of force. Bruised fists, stones and balls, blows, and traffic accidents are common causes of eye bruises. The blood vessels around the orbital tissue are rich in distribution, and the facial face is subject to blunt blows, which easily causes subcutaneous bleeding and bruising. In addition, the transmission of blunt force in the eyeball and the ball wall will also cause multiple indirect injuries, causing intraocular hemorrhage, orbital fractures, corneal and scleral rupture, and retinal detachment.

Mechanical eye trauma

Overview of mechanical eye trauma

Clinical symptoms of mechanical ocular trauma

If foreign matter enters, it is easy to damage the cornea of the patient, and the gradual development may cause corneal opacity, ulcers and white spots, affecting vision and appearance; if the foreign matter directly enters the inside of the eye, that may bring patients Greater damage.

There are generally two types of foreign bodies that enter the eye, one is magnetic foreign body, and the other is non-magnetic foreign body. The magnetic foreign body includes iron and its alloys, and the non-magnetic foreign body includes non-magnetic metals such as copper and aluminum. Stones, plants, etc .; if metal foreign matter enters, it may form chemical damage to the patient's eye, such as rust may seriously damage the tissue in the eye, and if plant foreign matter enters the eye, it may also Causes the occurrence of endophthalmitis.

Mechanical eye injuries such as eye contusions, sharps injuries, and explosion injuries can cause penetrating or rupturing injuries to the eyeball, and severely damage eyeball tissue. Contusions in the orbit and skull can cause orbital fractures, skull fractures, brain damage, eyeball and optic nerve damage, and often affect vision. Contusion of the eye can cause iris rupture, anterior chamber and vitreous hemorrhage, retinal hemorrhage, edema, hiatus, detachment, and secondary glaucoma.

In addition to causing damage to the eye tissue, the ocular hemorrhage, infection, and foreign body retention caused by mechanical eye trauma can not be ignored. For example, penetrating eyeball injuries can cause sympathetic ophthalmia, causing blindness in both eyes.

Types of mechanical eye trauma

Mechanical ocular trauma includes non-perforated trauma (mainly blunt contusion of the eye), perforated ocular trauma, and other foreign body injuries. These traumas can cause sympathetic ophthalmitis. How should we properly deal with mechanical trauma and reduce eye damage?

Blunt contusion of the eye

The common injuries caused by blunt eyeballs are as follows:

1) Subcutaneous bleeding of the eyelid and emphysema of the eyelid are blunt contusions of the eye, combined with a fracture of the medial wall of the orbit (usually the ethmoid sinus), and the gas in the ethmoid sinus enters the subcutaneous endothelium and causes subcutaneous blood stasis and emphysema, which usually disappear on their own, with Prevention of infection when subcutaneous emphysema;

2) When the corneal epithelium is exfoliated, apply antibiotics, eye ointment to prevent infection, and cover the injured eye;

3) Anterior chamber hemorrhage is caused by iris or ciliary body bleeding. When the amount of bleeding is large, the cause of glaucoma can be secondary; bed rest takes a semi-seated position, so that blood deposits below the anterior chamber do not cover the pupil, and hemostatic drugs are appropriately applied; secondary Glaucoma patients should take intraocular pressure-reducing drugs internally; if necessary, perform anterior chamber puncture;

4) Iris root dissection and traumatic pupil dilatation. Those with a small dissociation range usually do not get better. Those with a large dissociation range should undergo surgery and suture to return to their original position. Amniotic sphincter paralysis or tear caused by trauma is often caused by trauma. Difficult to recover;

5) Patients caused by vitreous hemorrhage, ciliary body choroid or retinal hemorrhage, should be less active, and appropriate application of hemostatic drugs;

6) After retinal concussion injury, retinal turbid edema is grayish white and can disappear on its own; severe trauma can cause retinal holes, resulting in retinal detachment, which requires surgical treatment;

7) Traumatic cataract and lens dislocation can cause secondary glaucoma;

8) Choroid hemorrhage and rupture. The rupture in the early stage of injury is often covered by bleeding. After the bleeding is absorbed, the rupture is exposed as a gray-white crack, arched, and the concave surface is facing the nipple;

9) Rupture of the eyeball and severe blunt contusion can cause the eyeball to rupture. The former is more common in the limbus of the cornea and the latter is more common around the optic nerve. The former can be sutured surgically, and the latter can be difficult to seek medical treatment.

Perforated eye trauma

Eyes are punctured by sharp objects (such as needle scissors, iron pieces, iron nails, lead wire or glass, etc.) or small foreign objects flying at high speed (usually small metal pieces). At the time of the injury, the patient immediately had a stream of "hot water" flowing out of the eye. After the injury, the patient was ashamed, had tears, pain, blood was not flowing through the eyes (there was a blood clot in the anterior chamber), and his vision was decreased. It was found that there was a penetrating wound in the front of the eyeball. Corneal limbus or sclera; new cases with shallow anterior chamber or decreased intraocular pressure, often with iris or other eye contents prolapsed or embedded in the wound, combined with anterior chamber hemorrhage or lens opacity.

Depending on the presence or absence of tissue in the eye, the wound treatment methods are different:

1) Penetrating wounds in the front of the eyeball without wounds coming out of the eye tissue, the possibility of contamination is small, wound suture can be performed; if there is bleeding in the anterior chamber, gently rinse and then suture, and inject normal saline or air into the anterior chamber to For the formation of the anterior chamber, antimycotic drugs are usually applied locally and systemically to prevent infection;

2) There are wounds in the eye tissue, and there is a little iris prolapse. Those with a shorter injury time can still recover the iris prolapse. The iris prolapsed for a long time (more than one day) and the polluted person is safe to remove;

3) Other treatments are the same as suture wounds and prevent infections for those without tissue loss. When the pigmented membrane tissue is injured, the possibility of sympathetic ophthalmitis always exists. If the injury is severe, the eye content is prolapsed a lot, and it may be too difficult to restore satisfactory and useful vision. If there is still hope, an eyeball excision should be performed. People with vision should be actively treated, and the eyeballs cannot be easily removed.

There are still many cases of mechanical eye trauma. Sometimes due to car accidents, improper work, etc., it is likely to cause serious eye damage. I believe everyone has heard of this situation, but the specific clinical machinery It may not be clear what the symptoms of ocular trauma are, let s take a look at the explanations of related experts.

Mechanical ocular trauma foreign body injuries include conjunctiva, corneal foreign body and intraocular foreign body

1) Conjunctival and corneal foreign bodies. Conjunctival foreign bodies are often located on the upper eyelid. The conjunctiva, especially in the area under the meibomian sulcus, is large. Foreign bodies may be located in the upper fornix conjunctiva. Conjunctival foreign bodies can be wiped out with a wet cotton stick. Common corneal foreign bodies are iron filings, cinders, glass slides, etc .; superficial foreign bodies are removed under local anesthesia with a wet cotton swab; deep foreign bodies are removed by injection needles or foreign body knives. After removal of corneal foreign bodies, care must be taken to prevent infection. Corneal ulcers occur frequently after removal of a corneal foreign body and can cause blindness;

2) Foreign bodies in the eye, there are many types of foreign bodies in the eye, the most common is iron filings, followed by other metals, glass pieces, small stones or wood chips, etc. It is more common for people to strike with a hammer or grind with a lathe, and small iron pieces are fast. When entering the eye, the patient suddenly burst into tears (usually the aqueous humor), and foreign matter penetrated through the cornea. The penetrating traces of the cornea were visible with a slit lamp. Small foreign objects entering the eye from the sclera sometimes could not find the wound. Sometimes foreign bodies enter the eyes through the pupil, but foreign bodies can be found on the iris. If the lens is penetrated, traumatic cataracts occur. If the lens is swollen, it can block secondary angle glaucoma. The metal foreign body can be confirmed by X-ray photography.

Mechanical eye trauma sympathetic ophthalmitis binocular granulomatous uveitis

Uveitis occurred in one eye after penetrating injury, and the same lesion occurred in the other eye. The injured eye was called irritated eye, and the uninjured eye was called sympathetic eye. Where the wound is in the ciliary body, where the uveal or lens is embedded in the wound or the foreign body is retained in the eye, sympathetic ophthalmitis is more likely to occur. The interval between the occurrence of penetrating injury and the apparent symptom of sympathetic eye is reported. Short days are 9 days old, 50 years are old, 90% of them occur within one year, and 4 to 6 weeks after injury are the most dangerous time.

Treatment of mechanical eye trauma

When the eyelid is lacerated, sometimes a large amount of bleeding is caused by damage to the blood vessels. At this time, the patients and their families should not be panicked. They can be covered with sterile gauze or other sterile items such as napkins, and then bandaged. Can temporarily stop bleeding.

If there is no bandage at home or at the scene, a long handkerchief or long towel can be used instead of the bandage to pressurize the bandage, and then sent to the hospital for debridement and suture treatment.

For horny, scleral perforation injuries and eye contents (such as iris, vitreous body, etc.) prolapse, they should be pressure bandaged before being sent to the hospital.

If you do not apply pressure bandaging, you will be taken to a hospital by car, which will cause the patient to lose all the contents such as vitreous body due to the long distance and prolonged bumps of the car.

Therefore, those patients with perforated eyeball injuries and detachment of eye contents must be pressure bandaged before being sent to the hospital, otherwise it will cause irreparable consequences. In patients with ocular trauma, in principle, debridement and suture should be within 24 hours after trauma, otherwise, the effect of surgery will be seriously affected.

Self-management method for mechanical eye trauma

We must do our best to get early treatment and treatment at the hospital.

Do not rub your eyes after eye trauma. Keep the wound as it is. There have been clinical examples of rubbing the eyes and rubbing out the tissues inside the eyes, causing the eyeballs to be repaired and removed.

In case of trauma to the eye, you should go to the ophthalmology department of the hospital in time. Remember not to apply hot compresses or order your own eye drops before going to the clinic.

The patient should be seated or lying in a supine position before going to the clinic.

Don't remove the foreign body that caused penetrating injury after the injury. You should perform a simple debridement treatment in a nearby medical office. After bandaging the injured eye, send it to the hospital ophthalmology or ophthalmology hospital for further treatment as soon as possible. Foreign body removal surgery.

Actively cooperate with the treatment according to the doctor's treatment plan.