Eye injuries and eye infections are very common. They can happen at any age from early childhood, the period of work activity to old age. They can occur in both sexes, they are more common in men who are working. Eye injuries can occur everywhere at work due to the non-use or inadequate use of protective equipment-glasses (table workers, metal-turners, welders, farmers), during sports, traffic accidents, but also in home conditions.
Injuries can be caused by:
- mechanical forces-contusion blunt injuries of the eye sockets and eye
- chemical injuries with acids and bases
- effect of increased heat – burns
- radiation injuries due to radiation
- injuries with the presence of a foreign body (metallic foreign body, glass, organic foreign body-greens)
A contusion injury (hand, elbow, ball…) can be limited to the eyelids and the front segment of the eye, but if the force is strong, it can affect the back segment of the eye and even lead to the rupture of the eyeball.
On the eyelids, the formation of hematomas can occur – bruising and swelling, abrasions, but also lacerations of the skin that can also affect the deeper layers of the muscle fibers.
Hematoma and edema of the eyelid
Contusions can lead to conjunctival bleeding, suffusion, and lacerations.
Rupture of blood vessels of the iris and the appearance of blood in the anterior chamber of the eye – hyphema – can occur, which can lead to serious consequences if the condition is not treated adequately and in a timely manner, there can be a rupture of the pupil sphincter and a permanent residual wide pupil – traumatic mydriasis. The iris can be split in the root part – iridodialysis.
Traumatic mydriasis and dialysis
The lens can be partially or completely displaced from its place – subluxation and luxation of the lens with a possible consequent secondary increase in intraocular pressure.
Bleeding in the area of the vitreous body – hemophthalmus often occurs, as well as numerous retinal and subretinal hemorrhages. Retinal rupture with or without subsequent retinal detachment, retinal dialysis, choroidal ablation, choroidal effusion. Edema of the posterior hemisphere of the eye – Berlin’s edema due to concussion – affects the posterior hemisphere of the eye.
Rupture of the bulb with prolapse of the uveal tissue is the most severe consequence of contusion force.
A hematoma can form behind the eyeball which can lead to suppression of the bulb and the appearance of double images.
A strong force can lead to a fracture of the orbital bones, most often the floor of the orbit, and prolapse of the contents of the eye downwards – a “blow out” fracture.
Chemical injuries – causoma can occur in domestic conditions – chemicals used in the household as well as in industry at the workplace. They can be with acids or bases (more severe clinical picture) or agents of unknown composition. Before coming to the ophthalmologist, it is recommended to wash the eye as early as possible, even with plain water from the tap, if saline solution is not available. That moment will determine the prognosis of the eye later.
Corneal leukemia as a result of chemical injury
Chemicals can cause serious damage to the structures of the eyelids, iris and cornea of the eye, and when it comes to bases, they can penetrate deeper structures and cause serious consequences for vision and the eye.
The thermal effect can most often be caused directly by burns of the cornea with the heat of a cigarette – combustio, it is treated in the same way as a chemical injury, the eye is not closed during this procedure so that the heat, or in the previous case, the chemical is emitted as much as possible over the surface of the eye into the environment.
Radiation injuries, UV rays damage the front structures of the eye – eyelids, conjunctiva and cornea, e.g. “snow blindness” or during digestion after a few hours of discomfort due to the erosion caused by UV rays ophthalmia electrica.
Infrared rays can damage the macula / foveola permanently when looking directly at the sun, for example. solar eclipse phenomenon.
Foreign bodies, obtained during grinding – metal or wood, with sharp edges and high speed of movement can remain on the front segment of the eye, conjunctiva or cornea, but can penetrate the cornea or sclera and reach the inside of the eye where, due to damage to the fine structure of the eye, bleeding or through an introduced infection – endophthalmitis can seriously threaten vision and the eye itself as an organ.
Metallic foreign body at the limbus of the cornea
Penetrating injuries of the eye with or without a foreign body present, rupture of the eyeball with or without prolapse of the internal contents of the eye, endophthalmitis, retinal detachment especially if the macula is not affected, lacerations of the eyelids require urgent surgical intervention.
Corneal sutures, monofilament 10.0
The majority of conditions are treated with conservative treatment and with a favorable outcome, it is only necessary to contact an ophthalmologist as soon as possible for timely treatment.
- Timely and adequate therapy enables preservation of sight and eye.
- Any eye injury, even seemingly harmless ones, requires an immediate examination by an ophthalmologist!
- You should always suspect an intraocular foreign body until proven otherwise with X-ray or CT of the eye / orbit!
- Only chemical injuries require urgent rinsing in home conditions for the first half hour and during transport, even with plain water, before going to the ophthalmologist.
- If an open injury is suspected, cover the eye with sterile gauze until examination.
- If there are visible foreign bodies, do not try to remove them, this will be done by an ophthalmologist using a biomicroscope or an operating microscope!