Physical or chemical injuries of the eye can be a serious threat and may lead to vision loss if treatment is delayed.
Although most patients with eye trauma present symptoms such as redness, pain or blurring of vision upon their arrival in the clinic, certain types of trauma do not give rise to any symptoms. This occurs either when the trauma is caused by a small foreign body or when the foreign bodies go into the ‘inner part’ of the eye where the vitreous gel or the retina is. Eye trauma involving the posterior segment of the eye or intraocular foreign bodies is considered as an ocular emergency hence should be evaluated by an ophthalmologist immediately.
Common conditions that are associated with eye trauma are as follows:
Corneal abrasion may occur as a result of the eye’s contact with dust, dirt, metal particles or other sharp objects that may scratch the cornea. Most cases are superficial although the abrasions may become infected and turn into a corneal ulcer, which is a severe eye problem. Symptoms of corneal abrasions include sandy feeling in the eyes, pain, tearing, blurring of vision and increased sensitivity to light.
Regardless of the types, foreign bodies that penetrate into the eye have to be removed the soonest possible to prevent severe vision loss.
Symptoms of chemical injuries may range from mild irritation to severe loss of vision. Chemical burns from acid may give rise to symptoms such as redness and burning sensation in the eye, but they are not as penetrating and hazardous as alkali. Due to its high pH, alkalis can easily penetrate the surface of the eye hence causing damage to the cornea and even the crystalline lens in the eye. The first line of treatment for all types of chemical burns is prompt and thorough rinsing of the eye with saline or water for about 15 minutes to reduce the risk of permanent damage to the eye and then visit your ophthalmologist immediately.
Swelling and bruising of the eyelids may result from blunt trauma to the eye (i.e. a punch, a ball hitting the eye). You should see an ophthalmologist the soonest possible to exclude any sight-threatening damage to the eye as a result of the injury.
A hyphema refers to bleeding in the anterior chamber of the eye. It is a common finding following blunt trauma to the eye and may coexist with elevated eye pressure in the eye. Patients are usually advised to stay in an upright position to help the blood settles and clears slowly. Patients with hyphema need to be reviewed very closely due to the raised pressure in the eye that may damage the optic nerve hence causing loss of vision.
Blunt impact to the eye may cause the thin bony orbital walls to break. These walls mostly heal well with no long-term problems. However, in some cases, the broken walls may create a ‘hinge’ that traps the orbital fat or extraocular muscles around the eyeball. In this case, a surgery will be required to repair the break.
A subconjunctival haemorrhage involves leakage of blood from small blood vessels that break open at the white surface of the eye. It is fairly common and may occur even without any injury to the eye. Despite its appearance, a subconjunctival haemorrhage is painless and does not give rise to any visual symptoms. The blood will clear by itself over a period of time and the eye will return to its normal appearance. No treatment is required for this condition.