Eye Trauma

Examination

Eye injuries can occur at any time. Our office is equiped to handle most eye injuries. The primary instrument we use is a biomicroscope, sometimes referred to as a slit lamp. The biomicroscope has a high magnification and is particularly designed to aid us in evaluating the extent of an eye injury. Whether it is a laceration, foreign particle embedded or a burn, the biomicroscope is the primary tool to carefully examination the injury.

Embedded Foreign Bodies

A common injury is a hot iron metalic foreign body embedded in the cornea. Grinding or drilling in iron or other metals will release particles that are hot and when they hit the eye they embed themselves in the cornea. If it is iron, as in this example, it will immediatley begin to rust due to the salty consistency of our tears. When the metal particle is removed, there is a remaining rust deposit that has infiltrated the surrounding cornea. We have experience at removing these rust spots. With proper medical treatment these injuries resolve well.

Retinal Trauma

Contusions, otherwise referred to as a "black eye" can result in more than just the obvious bruises on the face. The retina is the nerve tissue that senses light which lines the back of the eye. There is a blood vessel layer under the retina. This is very delicate and sensitive tissue.

Hemorrhages

A compression type of injury can knock the retina loose and cause bleeding underneath. Eye injuries can cause both retinal hemorrhage and retinal detachment, and both can result in blindness to the effected eye. Immediate examination and subsequent treatment is needed in these type of injuries.

For Emergencies during office hours

210-764-1113

For Emergencies after hours

210-601-9653

Eye Injuries Causes

• Chemical exposures and burns: Often the result of a splash of liquid getting in the eye, a chemical burn can occur in a number of ways. Many chemicals, such as soap, sunscreen and even tear gas, are primarily irritants to the eye and do not usually cause permanent damage. However, acids and alkalis are highly caustic and can cause severe damage.

• Acids (such as sulfuric acid found in car batteries) or alkalis (such as lye found in drain cleaner and ammonia can splash into your eyes.

• Rubbing your eye can transfer chemicals from the skin on the hands to your eye.
• Aerosol exposure is another method and can include such chemicals as Mace, tear gas, pepper spray, or hair spray.
• Corneal abrasions:  The cornea can be thought of as special, transparent skin that covers the eye. A corneal abrasion is, in effect, a scratch or an abrasion of that specialized skin. People with corneal abrasions often report that they were "poked" in the eye, often from a finger or some foreign object.
• Traumatic iritis: this type of injury can occur in the same way as a corneal abrasion. It is also associated with a blow to the eye from a more blunt object. The iris is the colored part of the eye. It is actually a muscle that controls the amount of light that enters the eye through the pupil.  Iritis simply means that the iris is inflamed.
• Lacerations to the cornea and the sclera: These injuries are very serious and are frequently associated with blunt trauma of flying objects.
• Foreign bodies in the eye: Generally, a foreign body is a small piece of metal, wood, or plastic filing. It could be anything that gets into the eye.

• Corneal foreign bodies are embedded in the cornea and have not penetrated the eye itself. Metal foreign bodies in the cornea can cause a rust stain, which also requires treatment.

• Intraorbital foreign bodies are in the orbit (or eye socket) but have not penetrated the eye.

• Intraocular foreign bodies are injuries in which the globe of the eye has been penetrated by the object.   
• Ultraviolet keratitis (or corneal flash burn): The most common light-induced trauma to the eye is ultraviolet keratitis, which can be thought of as a sunburn to the cornea. Sources of damaging ultraviolet light are arc welders, tanning booths, and the sun.

Eye Injuries Symptoms

• Chemical exposure: The most common symptoms are pain or burning. The eye may become red, and the eyelids may become swollen.
• Subconjunctival hemorrhage (bleeding): Generally, this condition is painless. Vision is not affected. The eye will have a red spot of blood on the sclera (the white part of the eye). This occurs when there is a rupture of a small blood vessel on the surface of the eye. The area of redness may be fairly large, and its appearance is sometimes alarming. It is not dangerous and generally goes away slowly with no treatment.
• Corneal abrasions: Symptoms include pain, a sensation that something is in the eye, tearing, and sensitivity to light.
• Iritis: Pain and light sensitivity are common. The pain may be described as a deep ache.  Sometimes, excessive tearing is seen.
• Hyphema:  Pain and blurred vision are the main symptoms.
• Orbital blowout fracture: Symptoms include pain, especially with movement of the eyes; double vision that disappears when one eye is covered; and eyelid swelling after nose blowing. Swelling around the eye and bruising often occur.
• Conjunctival lacerations: Symptoms include pain, redness, and a sensation that something is in the eye.
• Foreign bodies 

• Corneal: A sensation that something is in the eye, tearing, blurred vision, and light sensitivity are all common symptoms. Sometimes, the foreign body can be seen on the cornea. If the foreign body is metal, a rust ring or stain can occur. 

• Intraorbital: Symptoms,such as decreased vision, pain, and double vision, usually develop hours to days after the injury. Sometimes, no symptoms develop. 

• Intraocular: You may have eye pain and decreased vision, but,initially, you may have no symptoms.

When to Seek Medical Care

In most cases, if you have continuing symptoms of pain, visual disturbance, or bleeding, you should go to an ophthalmologist (a medical doctor who specializes in eye care and eye surgery). 

In general, if you are not sure if you have a serious eye injury, call your ophthalmologist for advice.

Calling your ophthalmologist may be helpful in the following circumstances:

• Chemical exposures: If you are not sure if the exposure is potentially serious, you have washed out your eye, and you have few symptoms, then your ophthalmologist may be able to help you decide whether or not you should be seen immediately.
• Subconjunctival hemorrhage:  If you are not sure that you have this condition, your ophthalmologist may be able to help with the diagnosis. This condition does not require immediate medical attention.
• Continuing pain and decreased vision after an eye injury can be warning signs that require prompt medical attention. If you have an ophthalmologist, he or she may be able to take care of you in the office. Otherwise, go to a hospital's emergency department.
• The following conditions should be seen promptly by an ophthalmologist or in the emergency department:
• Chemical exposures: If the substance was known to be caustic, immediate medical evaluation by either an ophthalmologist or in the emergency department is needed, regardless of symptoms. Acids and alkalis are the worst and require immediate attention. If the substance is not dangerous, such as soap or suntan lotion, a visit to the emergency department is not necessary, but a visit to the ophthalmologist's office may be helpful to alleviate any remaining symptoms. When in doubt, seek medical attention.
• Lacerations: Cuts that affect the eyelid margins (where the eyelashes are) or the eyeball itself need immediate medical attention.
• Foreign bodies that are not removed with gentle washing should be evaluated by an ophthalmologist.
• Solar retinopathy: Evaluation by an ophthalmologist is necessary. This is one condition where there is little that can be done in the emergency department.