Injuries to the eye

definition

Injuries to the eye can be caused by numerous triggers, such as blows, bumps, stabs, UV rays or caustic substances and can in principle affect all structures of the eye, including eyelids, tear organs, cornea, conjunctiva, retina, vitreous humor and optic nerve.

It is also possible to injure several of these structures at the same time. Injuries to the eye vary greatly in their extent and range from superficial, mostly harmless injuries to serious, deep-reaching injuries that penetrate the eye and can lead to loss of vision. Injuries to the eye can be accompanied by severe pain, although the severity of the pain often does not allow any conclusions to be drawn about the extent of the injury to the eye. Since the severity of the injury by the person concerned cannot be foreseen and some injuries to the eye can lead to blindness, acute or as a long-term consequence, it is advisable to consult an ophthalmologist in any case.

causes

There are numerous causes for injuries to the eye. Injuries to the eye are often of mechanical origin. You will also find an overview of the most common causes.

• Injuries from foreign objects in the eye
• Blue eye
• Bruised eyeball
• Fractures of the eye socket
• Retinal detachment
• Burns to the eye
• Physical injury to the eye
• As well as diseases caused by vascular injuries in the area of ​​the eye

Foreign matter in the eye

Foreign body injuries are relatively common in ophthalmology. The patient usually complains of a sudden foreign body sensation with simultaneous strong tear formation. Foreign objects can get into the eye of the person concerned during leisure activities or work accidents and cause superficial but also deep, penetrating injuries. In many cases, the patient can remember the situation and may be able to tell the doctor what and how a foreign object got into their eye. In addition to numbing and fluorescent eye drops, the ophthalmologist puts a blue light into the eye. This enables him to recognize the smallest scratches that light up yellow. Treatment is with eye ointment or eye drops containing antibiotics, which the patient must take for several days.

Further information on this topic can be found at: Foreign matter in the eye

Blue eye

A black eye, colloquially violet, is a bruise (Hematoma) around the eye. It occurs as part of an external impact from a blow or fall. It takes around two weeks for the skin around the eye to turn completely normal. When treating a hematoma (bruise) on the eye, as with all bruises, particularly rapid cooling is necessary immediately after the stain has been caused.

Read more on this topic at: Blue eye

Bruised eyeball

The blunt force of force in the area of ​​the eyeball or the eye socket causes the eyeball to bruise. The bruise of the eyeball occurs, for example, by punching a fist, throwing a snowball, or corking champagne. There is pain and, depending on the severity of the bruise, deterioration in vision. Double images are temporarily possible. The increased intraocular pressure is lowered with medication and controlled through constant follow-up examinations. Retinal injuries are usually treated with laser surgery.

This topic might interest you: Bruised eyeball

Fractures of the eye socket

Also of mechanical origin are fractures of the eye socket caused by blows or bumps to the eye, for example in the context of accidents, as well as open injuries to the eye caused by cuts, stab wounds or bite wounds.

Also read our topic: Orbital floor fracture and Orbital hernia

Retinal detachment

Retinal detachment is the separation of two layers of the retina from one another. The causes are hereditary, lack of attachment of the two layers, cracks in the retina, diabetes, bleeding from the vessels of the choroid membrane covering the retina or tumors (due to displacement of the retina). The complaints are sometimes announced by flashes of light and visual impressions that are described by those affected as "small mosquitoes", "falling curtains" or "billows of smoke". The only effective treatment option is to quickly surgically join the two retinal layers (otherwise the patient may become blind).

For more information, see: Retinal detachment

Burns to the eye

In the field of industrial and occupational medicine in particular, it often happens that injuries caused by chemical substances, especially acidic or alkaline liquids, occur. If the eye is burned, pain occurs in and around the eye. In any case, the chemical burn of the eye is an acute emergency which requires immediate first aid measures directly at the scene of the accident and medical treatment. As a first measure, the eye should be rinsed directly with an eye wash bottle. Alternatively, the opened eye can be held under running water or rinsed with the help of a hose. The eye must be open.

Further information on this topic can be found at: Burns to the eye

Physical injury to the eye

Furthermore, injuries to the eye due to physical causes are possible. These include burns of structures of the eye, especially the cornea, from sunlight (UV radiation) that can arise, for example, when looking intensively at the sun or during activities in the snow. Even during welding work, the strong UV radiation can damage the cornea, which is known as flashing.

Eye diseases from injuries to blood vessels

There are also different causes among the eye diseases caused by injuries to vessels in the area of ​​the eye. Some assume an underlying disease that can also affect the rest of the body. The most important are listed below.

• Bruise in the eye
• Vitreous hemorrhage
• Circulatory disorder of the eye
• Arterial occlusion of the eye

Bruise in the eye

With a harmless bruise in the eye, which is caused by broken veins, there are usually no further symptoms. However, accompanying pain around the eye and severe headaches can occur. Most of the time, bruises heal on their own and do not require any specific therapy. If a bruise in the eye does not go away after 2 days or if any side effects occur, a doctor should be consulted. An examination should also be done if the bruises recur in the eye.

Read more on this topic at: Bruise in the eye

Vitreous hemorrhage

Vitreous hemorrhage is the penetration of blood into the vitreous space of the eye. This is located behind the eye lens. Bleeding from retinal vessels, for example, is a possible cause. This happens when the retina becomes detached from its support. Vessels can tear off and cause this bleeding. The symptoms can vary in severity. At the beginning it is often expressed in a change in image perception. There can also be flashes of light. The type of treatment for vitreous hemorrhage depends on a number of factors. An ophthalmologist should be consulted for further clarification.

Also read our page on this topic: Vitreous hemorrhage

Circulatory disorder of the eye

With a circulatory disorder of the eye - usually the retina or the optic nerve, the patient's vision decreases rapidly without pain. The main causes are high blood pressure and diabetes. It is important that these causes are treated so that the vessels do not become blocked or constricted in the first place.

You will find more information on this topic here: Circulatory disorder of the eye

Arterial occlusion of the eye

If the central artery or the small arteries branching off from it become blocked, the patient becomes blind in the affected eye suddenly or possibly for a limited time. The blindness can persist until appropriate therapy has been initiated or it can only last for a short time. The ophthalmologist should be seen immediately. Even with immediate therapy, the chances of success in case of an arterial occlusion of the eye are very low, since the sensory cells are irrevocably destroyed after just 60 to 90 minutes.

You can find everything on this topic here: Arterial occlusion of the eye

therapy

In the case of injuries to the eye, it is generally advisable to see an ophthalmologist as soon as possible. With some injuries to the eye, however, it is helpful to take steps to prevent the injury from progressing before you visit your ophthalmologist.

This is particularly the case if the eyes are burned with alkalis or acids.
As an immediate measure, an attempt should be made to rinse the affected eye with plenty of clear water to prevent further penetration of the chemicals. Even with superficial foreign bodies, it may be useful to carefully remove them.

Foreign objects that are firmly in the eye or that penetrate it should not be removed under any circumstances, but should be left in the eye, otherwise the eye can be further injured.

An ophthalmologist should then be consulted who can diagnose the injury to the eye using various examination methods, assess its severity and then initiate the necessary therapy.

In the case of a large number of injuries to the eye, no therapeutic measures are necessary, as these have a high self-healing rate. These include superficial wounds or small cuts, for example caused by foreign bodies, as well as slight bruises.

Furthermore, in the case of minor injuries to the eye, it may be necessary to administer eye drops and ointments containing cortisone or antibiotics, as well as applying an eye bandage or a cooling compress.

Serious injuries to the eye usually have to be treated surgically in order to maintain the functions of the eye. Depending on the type of injury to the eye, different surgical procedures are used. Operations on the eye can be performed under general or local anesthesia.

In the surgical treatment of injuries to the eye, however, the operation itself can lead to further injuries to the eye, as well as complications in the form of bleeding, secondary bleeding, wound healing disorders and infections. After surgery on the eye, the patient should not drive a car for 24 hours and should take it easy for the next few days. If complications arise, the ophthalmologist should be consulted again.

Symptoms

Depending on the cause, injuries to the eye can present with different symptoms.

In most cases there is a strong reddening of the eye, which is caused by irritation of the conjunctiva. The eye may be puffy, tearful, and blink frequently. Often there is also an unpleasant foreign body sensation.
In many cases, these symptoms are found in both the affected and unaffected eyes.

Another symptom of an eye injury is severe pain, which can worsen when you blink. These are particularly found in injuries to the cornea, as it is very sensitive to pain in contrast to other structures of the eye. So it happens that even slight, superficial injuries to the eye can cause massive pain in the affected person, for example if a small grain of sand rubs the cornea.

Read more on the topic: Eye pain

In the case of bruises or fractures of the eye socket, which can result from blows or bumps to the eye, bleeding and bruising can form, which are visible from the outside and can provide an indication of the origin of the injury. Bruising in the eye socket can compress the muscles of the eye and the optic nerve, causing double vision, impaired vision, or even complete vision loss.

Other optical phenomena that can occur in the event of injuries to the eye, especially the vitreous body and retina, are seeing black dots that move with the eye or seeing lightning bolts. In particularly serious accidents with massive forces acting on the eye, the optic nerve may be torn out, which is accompanied by immediate blindness in the affected eye.

diagnosis

Since some injuries to the eye can cause serious complications, such as blindness in the affected eye, injuries to the eye should be assessed by an ophthalmologist.

The focus is on a detailed questioning of the patient about the origin of the injury to the eye, as well as inquiries about symptoms of the patient, such as redness, swelling, pain, double vision, black dots or flashes or loss of vision. This detailed survey is known as anamnese.

It is also very important to take a close look at the affected eye inspection. Injuries to the eye are often visible from the outside (For example, firmly attached foreign bodies, bruises or misalignment of the affected eye compared to the unaffected eye) and can thus facilitate the diagnosis.

The anamnesis and inspection are followed by an examination of the eye, which tests, among other things, the ability to close the eye and the ability to move the eyes in different directions.
In most cases, locally anesthetic eye drops are used to prevent pain from occurring or worsened during the examination. In addition, various tests are used to check whether there is visual impairment or even a complete loss of vision.

An important examination tool that is also used to diagnose injuries to the eye is the slit lamp. With the help of the slit lamp examination, the anterior, middle and posterior segments of the eye can be examined and injuries that are not visible from the outside, for example injuries to the retina, can be detected.

In some cases, such as blows or bumps to the eye, examinations of the eye using ultrasound, X-ray or computed tomography (CT) become necessary.

forecast

Injuries to the eye are prognostic depending on their severity.

Often there are only superficial injuries, either heal by itself or outpatient from an ophthalmologist, for example in the form of eye drop can be treated.

Lying less often serious injuries before that operational must be taken care of and become a serious complication Blindness being able to lead. Both mild and severe injuries can lead to a bacterial colonization come from wounds, cracks or remaining foreign bodies and thus a Inflammation of the affected area of ​​the eye be evoked.

In such cases, treatment with Antibiotics required to prevent complications from the inflammatory response. In the event of injuries to the eye, the Tetanus protection of the patient and if the vaccination protection is insufficient, a booster vaccination can be carried out.

prophylaxis

The most important measure to prevent injuries to the eye is that Wear suitable protective goggles. In certain professions, protective goggles are part of work clothing and thus provide reliable protection against you, for example Penetration of foreign bodies in the eye, before Chemical burns or before Lightening.

Even outside of work, wearing glasses, such as wearing sunglasses when looking in the sun or skiing, as well as wearing special plastic glasses for ball sports, can protect against eye injuries.