Makindo Medical Notes

Introduction

• Eye trauma refers to any injury to the eye or surrounding tissues caused by direct or indirect force, foreign objects, or exposure to chemicals.
• It can range from minor injuries like corneal abrasions to more severe conditions like globe rupture or chemical burns, potentially leading to permanent vision loss if not treated promptly.

Clinical Features:

• Pain: Depending on the type of trauma, pain can be mild (in corneal abrasion) to severe (in penetrating injuries).
• Redness and Tearing: Common in most forms of eye trauma.
• Photophobia: Sensitivity to light, especially in corneal abrasions and chemical burns.
• Decreased Vision: Can occur in penetrating injuries, hyphema, or blunt trauma.
• Visible Damage: Lacerations, foreign bodies, or blood in the anterior chamber may be visible.
• Swelling and Bruising: Often present with blunt trauma to the eye or surrounding tissues.

Investigations:

• Fluorescein Staining: A special dye that highlights corneal abrasions or foreign bodies under blue light during a slit-lamp examination.
• Slit-Lamp Examination: A detailed examination of the eye's structures to assess damage, especially in cases of corneal abrasion, foreign body, or hyphema.
• CT Scan of the Orbit: Used in blunt trauma to evaluate for fractures or soft tissue injuries, including entrapment of eye muscles in orbital fractures.
• Visual Acuity Testing: Always performed to assess the impact of the trauma on vision.
• Intraocular Pressure (IOP) Measurement: Important in cases of hyphema or globe rupture to assess for increased pressure inside the eye.

Types of trauma

Red Flags in Eye Trauma:

• Vision Loss: Any sudden loss of vision or significant visual disturbance following trauma requires immediate medical attention.
• Penetrating Injuries: If there is any suspicion of globe rupture or penetration, urgent surgical intervention is necessary.
• Chemical Burns: Immediate and aggressive irrigation is essential to prevent long-term damage.
• Hyphema: If left untreated, can result in increased intraocular pressure and permanent vision loss.
• Orbital Fracture: In cases where eye movement is impaired or there is double vision, urgent surgical intervention may be required to prevent complications.

General Management of Eye Trauma:

• Immediate Care: Shield the eye in cases of severe trauma without applying pressure, irrigate thoroughly for chemical injuries, and remove foreign bodies carefully if superficial.
• Medications:
  • Antibiotics: To prevent infection in corneal abrasions, foreign bodies, or penetrating injuries.
  • Pain Control: Analgesics or lubricating eye drops to manage pain.
  • Steroids: May be used for inflammation in some cases but avoided in corneal injuries unless prescribed by an ophthalmologist.
• Follow-up: Regular follow-up is essential, especially in cases of hyphema, orbital fractures, and chemical burns, to monitor healing and prevent complications such as glaucoma, infection, or permanent vision loss.