On the occasion of a shock, while practicing sports or even at home, eye injuries are frequent. It depends on their mechanism and the energy involved at the time of impact. While most are benign, they are still a legitimate source of concern. The most brutal, for their part, fall under genuine emergency care.
This article will provide details about ocular splashes, burns, and foreign bodies.
Generalities and mechanisms
Eye injuries are very common pathologies whose severity is extremely variable and will depend on the area affected the mechanism involved, and the intensity of the shock.
If prevention, professional and domestic, allows a reduction of risks, certain activities remain “accidental-prone”. There may be two causes: contusion by a blunt object or by wound, in this case, generally caused by a sharp object.
Trauma by eye contusion
Bruises are wounds produced by a shock, without breaking tissue. The eyeball remains closed and the structures of the eye are affected by the shock wave.
The injury is related to the rapid deformation of the crushed eyeball under the pressure of the impact. The smaller the blunt object involved, the higher the energy with which the blow is struck, and the greater the danger to the eyes.
Among the objects most frequently involved are balls (tennis ball, football, badminton shuttlecock), body parts (elbows, punches, headbutts, etc.), corks, and a whole variety of objects likely to strike the orbit.
Depending on the intensity of the shock, the victim may or may not have pain, decreased vision or not, redness (subconjunctival hemorrhage) or not, and numerous lesions, the most feared of which (in boxing in particular) is retinal detachment.
Sometimes the onset of symptoms is not immediate. For retinal detachment, for example, which is manifested by veiling and decreased vision, as well as for post-traumatic inflammation which is manifested by redness of the eye, discomfort with light (photophobia), and pain.
The symptoms appear after a few days. This is why the consultation during which a fundus examination will be carried out is essential.
They can be related to a foreign body or to the friction of a sharp object which would not have cut deeply enough to perforate the entire globe. In both cases an examination is necessary.
In the event of a foreign body, it will allow its removal. In the case of a non-perforating wound (sometimes with very few symptoms), it will make it possible to assess the severity and administer adequate treatment.
These types of wounds are the most serious types of wounds in the case of eyes. Exceptionally, they can be linked to an extremely violent contusive mechanism, but most often they are linked to a sharp object (nail, blade, sharp projectile, etc.).
The pain is unbearable. The suture must be done as soon as possible, in an emergency. Hospitalization is almost always required to administer intravenous antibiotics. Their prognosis is usually very poor.
Sports accidents and practice of boxing
Eye injuries are common among athletes, especially in children and young adults. Some sports are riskier than others, not always violent sports. Combat sports (boxing, martial arts), for obvious reasons, are on the front line.
Football, especially in its 5-a-side mode (urban football), is also a major source of severe eye injuries due to the proximity of players in the event of a strike and the lack of time to protect themselves. Ball sports of any kind can also cause injury, rugby, and any situation that has involved eye trauma.
Inflammation or post-traumatic hypertonia, benign complications, are also frequently observed (red and painful eyes). A fundus examination is essential and must be done immediately after any of these incidents occur.
Miscellaneous accidents :
Accidents on public roads (particularly windshield debris), domestic accidents (scissors), or attacks can cause direct wounds to the eyeball. Young children are particularly at risk of domestic accidents. Accidental liquid splashes are also common.
War games and dummy weapons such as paintball and ball guns, but also flash ball, as well as projectiles from real or dummy weapons, can have very serious consequences and damage the eyes of adults and children.
Complications, management, and treatment
Contusion trauma is the most frequent. Whatever the cause, the possible consequences are as follows:
- Sometimes a subconjunctival hemorrhage is present. Isolated, it is perfectly benign but can hide an underlying wound. In case of doubt, the ophthalmologist will recommend an exploration in the operating room.
- Frequently, an inflammation of the eye, which becomes red and painful, is observed. It is sometimes slightly delayed in time (a few days after the trauma).
- Ocular hypertension is also observed frequently. It is treated with hypotonic eye drops and sometimes with tablets. Untreated, it can result in hematocornea.
- A post-traumatic cataract can be observed in case of violent shock. It is manifested by a loss of vision and requires surgery.
- Retinal detachment is the most dreaded complication, as it is often asymptomatic at first. This is why any ocular trauma must benefit from an eye fundus. In case of tearing, a laser will be offered. In case of proven detachment, surgery will be performed without delay. This is a surgical ophthalmological emergency.
For non-permeating globe wounds, a directed (spontaneous) healing treatment will be prescribed to allow healing and avoid any infection. The prognosis will depend on the affected area. A small conjunctival wound will be of no consequence, whereas a corneal wound, even if not penetrating, will sometimes leave a significant scar (corneal pillowcase) which can lead to a significant drop in visual acuity.
Penetrating wounds, with some exceptions (self-sealing wounds in particular), always require emergency surgery. Their prognosis, except in rare cases, is often very poor, the issue sometimes being the preservation of aesthetics rather than visual function.
Prevention: protect your eyes!
Prevention is the best medicine. Protect your eyes and those of your children. Wear your protective glasses. Supervise the young children and keep your eye on the objects they play with to avoid accidents. You can also contact hospitals like JLR Eye Hospital for consulting any eye-related issues.
Name- Animesh Rai
Bio- Animesh Rai is a postgraduate in health and hospital management from the Indian Institute of Health Management Research, currently working as a Deputy Administrator at the Association for the Prevention of Blindness, a non-profit society, operating 200-bedded JL Rohatgi Memorial Eye Hospital. Hospital also has a training institute that offers full-time optometry courses in Kanpur.