What Are the Different Ways to Treat a Scratched Eyeball?

Penetrating eyeball injury is tissue damage caused by the eyeball being punctured by an external sharp device or the foreign body debris ejected at high speed through the eyeball wall. It often occurs in children and young adults. The severity of penetrating injuries is related to the size, shape, nature, speed of splashing, the location of the injury, the degree of pollution, and the presence of foreign bodies in the ball. It can cause intraocular infection, prolapse of eyeball contents, intraocular foreign bodies, and sympathetic ophthalmia, leading to blindness, which must be actively rescued and handled properly.

Basic Information

nickname

Eye penetrating injury, single perforation injury, non-penetrating trauma

English name

penetrating injuries to eye

Visiting department

Ophthalmology

Common causes

Caused by cutting or stabbing with a sharp blade or sharp object, foreign matter debris entering the eyeball, etc.

Common symptoms

Fear of light, tears or accompanying tears, pain after injury

Causes of eye penetrating injuries

Rupture of the eyeball due to cutting injuries or stab wounds with a sharp blade or pointed object, debris from foreign bodies entering the eyeball, and blunt injury to the eyeball.

Clinical manifestations of penetrating eye injury

1. Different degrees of vision loss.

2. Fear of irritation such as light, tears or accompanying tears, pain after injury.

3. Bulbous conjunctival ciliary congestion or mixed congestion or local congestion under the bulbar conjunctiva.

4. There are visible wounds in the cornea, limbus or sclera.

5. The anterior chamber may become shallow or disappear, and may be accompanied by hemorrhage.

6. Pupil deformation and displacement.

7. The wound has prolapsed or incarcerated tissue.

8. If the lens is injured, it can cause traumatic cataracts, and even the capsular rupture of the lens.

9. Reduced intraocular pressure.

Eye penetrating injury examination

A CT scan of the head can be performed to understand the trauma situation and whether there are foreign bodies.

Eye Penetrating Injury Treatment

Prevent infection

First wipe the eyelids and surrounding skin, and clean the eyes with a normal saline swab, but do not rinse. If contamination is suspected, wipe with 1: 5000 liters of mercury solution or mercury oxycyanide solution. After conducting various examinations and properly closing the wound, antibiotics were injected under the conjunctiva, and antibiotic eye drops were dripped into the conjunctival sac, and covered with gauze and bandaged. If the wound is larger and deeper and the wound is exposed for a longer period of time, antibiotics should be injected into the eyeballs, antibiotics should be applied in full amount throughout the body, and tetanus antitoxin or toxoid should be injected.

2. Close the wound

Properly treat the wound to prevent secondary infections and detachment of eye contents, stop bleeding, restore intraocular pressure, and maintain the normal position of each tissue structure.

3. Prevent bleeding

Care should be taken to prevent bleeding when the injury involves the uveal and retina. For hemorrhage, various hemostatic agents of western medicine and traditional Chinese medicine can be used. The patient is lying still, wounded eyes or both eyes are bandaged, and the eye shield is deepened to avoid vibration and pressure on the eyeballs. For those with more bleeding and slow absorption, vitreotomy is feasible.

4. Prevent inflammatory response

Heavier penetrating injuries, especially those who injure the uveal membrane, should pay attention to prevent inflammatory reactions, use dilated pupils, apply local and systemic corticosteroids, or take non-steroidal anti-inflammatory agents such as sodium salicylate, aspirin or indomethacin and Chinese herbal medicine for clearing heat and expelling wind.

5. Early vitrectomy

Severe eye penetrating wounds should be treated with vitrectomy at the same time as the first treatment and sealing the wound if necessary. In the early stages of suppurative endophthalmitis or pancreatitis, vitrectomy combined with antibiotic intraocular injection has a good therapeutic effect.

6. Management of eye penetrating injuries

Penetrating eye injury, that is, double penetrating eye injury or secondary perforation injury. While treating the front wound, the back wound should be treated. For posterior wounds, if suture is required, transvitreal diathermy can be performed to coagulate the retinal choroid around the wound. If the posterior wound is large, or there is obvious retinal detachment, the scleral wound should be sutured, and transscleral heat or condensation or scleral pad compression should be performed. Early vitrectomy should be performed for penetrating eye injuries.

7. Management of explosion injury

In addition to eye injuries during an explosion injury, attention should be paid to the treatment of craniocerebral, internal organs, and external injuries of the limbs during treatment. Life should be saved first. The blast injuries were mostly eyes, multiple wounds, or multiple foreign bodies remaining. Pay special attention to prevent infection during treatment. According to the location and degree of injury, refer to the previous method for treatment.

8. Treatment of purulent endophthalmitis

Try to perform vitrectomy as early as possible.