Eye injuries

What kinds of eye injuries exist?

Common eye injuries include injuries from foreign bodies, stab wounds, lacerations, bruises and hematomas. Also thermal and chemical burns occur. Ocular injuries can range in severity based on the cause. Injuries range from mild, superficial lesions to severe trauma involving internal structures of the eyeball.

The ones most commonly encountered are superficial injuries of the eyelid, tear ducts, conjunctiva or cornea. Penetrating eye injuries are more rare and refer to injuries in which the eyeball is opened. This is usually accomplished by penetration of a foreign body or by cuts as well as puncture wounds. In the event that the posterior eyeball wall is injured as well it, is referred to as a perforating eye injury. For example, such injuries arise when foreign bodies exit or strike the retina again. Penetrating and perforating eye injuries are very dangerous because they can cause blindness.

What are the most common causes of eye injury?

Eye injuries are often sustained when foreign objects penetrate the eye during work, traffic or recreational accidents. Metal particles can enter the eye during flexing, grinding or using hammers and chisels. Bruises and hematomas or even ruptures of the eyeball can be caused by blunt force to the eye, for instance from a stone or a champagne stopper. Cutting injuries to the cornea or sclera may stem from broken eyeglass lenses, exploding sparkling bottles or shattering windshields.

Flash burns are corneal and conjunctival injuries caused by ultraviolet light. They can happen when one looks into a high-altitude sun, welding flame,or sun-exposed snow at high altitudes without protection. Acids or bases entering the eye can corrode it. Superficial or deep burns inflicted by boiling water, hot grease or fumes are also possible.

Dog bite injuries are usually associated with lid laceration and tear duct trauma. Traffic accidents are a frequent cause of major penetrating injuries involving optic nerve lesions and are often associated with facial fractures.

How to recognize an eye injury?

Depending on the extent of the eye injury, it may be more or less apparent. Superficial injuries make the eye watery, with a reddened conjunctiva and often provoke a foreign body sensation. On top of that, penetrating or perforating eye injuries, but also corneal abrasions bring on severe pain, the eyelids may swell. Bruises of the eye often reveal hematomas or bleeding which may impair vision.

In the event of an injured eye, it should be inspected by an ophthalmologist. The history of how the accident occurred is very important and can provide first clues to the ophthalmologist. Often, because of the injury, the physician is unable to employ the standard examination equipment.

Usually, a local anesthetic must be dripped into the eye to allow for an examination. Initially, the doctor uses an intense light source to inspect the conjunctiva and cornea for any injuries or foreign bodies. In some situations, the cornea may be dyed with fluorecein to make injuries more visible. Next, the eye doctor will examine the anterior chamber of the eye, evaluate the pupil and search for any bleeding. By means of ophthalmoscopy, the back of the eye can be investigated. This will reveal any presence of bleeding in the vitreous body or retina as well as foreign bodies.

In addition, the ophthalmologist performs tests for a number of functions, such as eye mobility, position, pupillary response and visual acuity. An MRI or CT scan can be conducted in the case of severe injuries with suspected fractures. Deeply lodged foreign bodies can also be assessed in this way.

How to deal with eye injuries?

In case you suffer an eye injury, you should always consult a doctor, ideally an ophthalmologist. Sometimes, depending on how urgent and severe the injury is, you can also visit your family doctor, the emergency room of a hospital or contact an ambulance. If the initial care is provided by a different doctor, usually they will apply a sterile eye dressing for severe injuries and transfer the patient to an ophthalmologist or eye clinic.

Most superficial injuries will heal on their own. If necessary, an eye ointment or eye drops can be prescribed. Any visible foreign bodies are removed. Even superficial cuts or lacerations will heal on their own, only deeper injuries will have to be stitched. In the event of chemical burns, the eyes are washed to clear the harmful substances from the eye.

Deeper injuries require surgical treatment. Iris or lens injuries can be treated with surgery and an artificial lens might be implanted.

Serious eye injuries hematomas in the orbit of the eye are often followed by an increased intraocular pressure. In such cases, medications to lower the pressure are administered.

Accidents in which the bony orbit is injured must be treated surgically. If the injury to the eye is very severe or if there are foreign bodies in the vitreous body, usually a vitrectomy is indicated. This surgery aims to remove the vitreous body and replace it with a fluid or gas.  

Usually the eye heals completely. However, the severity of the injury may dictate the presence of complications regarding healing, for example in case germs enter the eye. Permanent damage such as misalignment of the eyelids, double vision, strabismus or glaucoma might be the consequence of an eye injury as well.

Which doctors and clinics specialize in eye injuries?

If you're in need of a doctor, you expect the best medical care possible. So of course patients are curious to find out what clinic to go to. As there is no objective way to answer this question and a legitimate doctor would never claim to be the best, patients must rely on a doctor's experience.

Let us help you find an expert for your condition. All doctors and clinics listed have been reviewed by us for their outstanding specialization in the field of eye injuries and are looking forward to your inquiry or wish for treatment.