Treatment of Traumatic Injury of Eyeball

About the disease

Traumatic injury of the eyeball is relatively common among facial traumas. Blunt and penetrative eyeball damage may result from a motor vehicle accident, fall or a fist fight, for example. Sports related eye injuries are also quite common, especially during ball games such as baseball, as the ball is particularly hard and flies very fast through the air. Being hit in the eye by a baseball can potentially cause blindness.

The workplace can also pose a risk of injury to the eyeball, especially when working with chemicals or processing metal. In a factory, for example, tiny shards of metal, glass, wood or sand may fly towards the worker’s face when using a drill or other machinery. Use of special safety goggles is essential in factories. There are also certain medications that can cause an allergic reaction in the eyeball.

Damage to the retina, vitreous humor or nerve endings is a medical emergency. Time plays a very important role here. Intraocular pressure needs to be stabilized immediately and any bleeding needs to be stopped. Delaying treatment may cause complications and the person’s ability to see may be at risk.

Symptoms

• Pain
• Gritty sensation
• The white of the eye becomes red
• Bleeding, in the some cases
• Blurred vision
• Halo vision
• Inability to see clearly, or to see at all

Diagnosis

• During a general examination, the doctor will examine the patient’s eye to determine the extent of the damage to the eyeball. The patient’s sight will also be checked.
• The patient should describe to the doctor how the injury occurred so that the doctor can determine the extent of the damage and decide upon a treatment plan.
• A topical anesthetic may sometimes be applied during the examination, to allow the doctor to take a closer look at the eye orbit and the eyeball itself. The doctor may direct light at the eye to check sensory reflexes.

Treatment

• In the case of an emergency, the doctor will irrigate the eye. This is often performed to treat chemical injuries.
• A pressure patch and suture may be applied to treat a physical injury to the eyeball. The patch must not be used if the patient was wearing contact lenses or if they suffer from a corneal abrasion, because of the risk of infection.
• Reconstructive eye surgery may be necessary in cases where the structures of the eyeball or the surrounding bones were damaged.
• Eyeball removal is performed in severe cases if it has been surgically impossible to preserve the eyeball and infection has spread. 

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko