An estimated half-million serious eye injuries occur each year in the United States. Twenty-five thousand of that number end up in total blindness. Young people under 25 make up the number one cause of vision loss. Fortunately, advances in microsurgical techniques over the past decade have allowed vision to be saved in some of these injured eyes.
Types of eye injuries
Eyelids – these can be serious because the eyelids protect the eyes and keep them moist, performing a task similar to that of a windshield wiper washing away foreign matter. If the eyelid loses its ability to cover the eye adequately, drying of the eye, infection, or clouding of the normally clear cornea can occur. The eyelids may swell dramatically after trauma often resulting in a black eye from blood collecting beneath the loose skin of the lid.
Tear ducts – this leads from the eyes to the nose and, if damaged, interrupts the normal drainage of tears. Proper surgical repair is necessary to maintain normal eyelid function and tear drainage.
Scrapes – common eye injuries of the outer surface of the eye known as a corneal abrasion. Fingernails, contact lenses, and paper edges are frequently the cause, but airborne particles that strike the eye during drilling, hammering, or working with cars are also offenders. These tend to be quite painful, usually prompting immediate eye examination, which consists of viewing the eye under a special microscope. Treatment involves removal of the foreign body (if present), installation of antibiotics, and patching of the eye. Close observation of the eye at regular intervals is then necessary to monitor for infection.
Chemical burns – a very serious injury of the eye. Damage from things such as hair spray can be minor and temporary, but others from substances like alkalis and acids can be severe and possibly blind. Alkali can be found in many household products like drain and floor cleaners. They should be used with extreme caution and be kept out of the reach of children. Acid burns generally occur from an exploding car battery. With any chemical injury, the eyes should be flooded immediately for ten minutes with any neutral fluid, such as water or soda pop to minimize the damage. Following that seek immediate emergency medical care.
Blunt trauma – occurs when the eye is struck with a finger, fist, racket, tennis ball, or another solid object. These injuries produce damage to the eye as a result of the sudden compression and indentation of the globe that occurs at the moment of impact. Bleeding may occur in the front of the eye between the clear cornea and colored iris, a condition referred to as a hyphema.
The normally clear lens may also be damaged, turning cloudy, thus forming a cataract that blocks light from getting to the back of the eye, or it may be displaced within the eye so that is can no longer focus a clear image. The retina, the delicate structure lining the back of the eye that receives light like the film in a camera, can also be damaged. Vision is reduced whenever that portion of the retina responsible for sharp central vision is affected, such as when a tear in the retina leads to a large retinal detachment.
Retinal detachments generally require prompt surgical repair to prevent or minimize serious visual loss. Sometimes, the effects of an eye injury may not become evident for months or years after the injury occurs. These late effects, including cataract, retinal detachment, or glaucoma (abnormally high pressure inside the eye), all may result in visual loss. Therefore, continued follow-up care is important to preserve vision after an injury.
Penetrating trauma – refers to injuries in which the eye is pierced by a sharp object such as a knife, or by a high-velocity missile such as a piece of metal or a BB pellet. Surgery is often needed to repair the damage. After any penetrating eye injury, a serious intraocular infection may develop that can rapidly lead to permanent blindness in that eye.
The advent of modern microsurgical techniques and the development of new antibiotics have improved the chances of saving many of these severely injured eyes.
Many eye injuries can be prevented if protective eyewear is used at work or during sports activities. If an injury does occur, prompt first aid may greatly improve the chances of preserving vision. Injuries involving chemicals such as alkalis and acids require immediate irrigation of the eye with a neutral solution.
For injuries from foreign bodies or from blunt or penetrating objects, a protective shield should be placed over the eye. In all cases, emergency care should be quickly sought.