Ocular Trauma - Causes, Symptoms, Diagnosis, and Treatment

Introduction

A person in their lifetime can experience an ocular trauma at least once. This is because people are prone to eye injuries, and one must be careful and follow all the preventive measures to avoid them. Ocular traumas can result from accidents, contact with chemicals (acids and alkali), sports activities, etc. This article will discuss the various causes of ocular trauma, its symptoms, diagnosis, and management.

What Are the Various Types and Causes of Ocular Trauma?

Ocular trauma can occur from various activities done in day-to-day life.

They are -

Chemical Burns - Chemical substances, when in contact with the eyes, can cause severe damage. Most often, the chemical tends to splash into the eyes accidentally. People handling acids and alkalis in their daily lives are most affected.

Alkali, such as ammonia, lime, and lye, are the few that cause alkali burns, and these are found in fertilizers, whitewash, fireworks, etc. Acids like sulfuric acid in batteries and hydrochloric acid in laboratories are familiar sources of acid burns.

Not just the splashing of the chemicals, but even rubbing the eye with hands exposed to chemicals can also cause burns to the eye. In addition, exposure to chemical aerosols from hair spray, tear gas, or any self-defense sprays is also found to cause burns.

Corneal Abrasions - The cornea is the outermost transparent layer of the eye. It can get abraded by getting poked with a fingernail, foreign objects, etc. The abrasion of the cornea is also known corneal abrasion. These are very common, and often the patient will present with pain, swelling, and eye redness.

Fractures of the Eye - Eyes are exposed to many traumatic events; few events can damage the bony part of the eye and cause orbital fractures. Even blunt force is found to cause fractures. An orbital fracture results from the breakage of the facial bones present in the surrounding area of the eye. Children are found to be more susceptible to orbital fractures.

Bleeding in the Eye - Trauma or straining the eyes too much, like coughing, sneezing, lifting heavy objects, or even blood thinners, can cause bleeding in the eye. The most common bleeding conditions of the eye are subconjunctival hemorrhage and hyphema.

A subconjunctival hemorrhage is a condition characterized by a red spot in the eye's white area. The white portion of the eye is called the sclera, which is layered by the conjunctiva, which carries the essential blood vessels. The blood vessels can leak during straining or trauma and form a red spot. In most cases, it does not need any treatment and subsides in a few weeks.

Hyphema is a painful eye condition that needs immediate attention; otherwise, it will result in permanent loss of vision. Trauma and increased intraocular pressure have been found to be the significant causes of hyphema. Herpes infection, abnormal blood vessels, hemophilia, sickle cell anemia, and cancer of the eye are the various causes of hyphema. Hyphema is characterized by blood collection between the corneal layer and the iris, specifically the eye's anterior chamber. It is a painful condition, and the pooling blood obstructs vision wholly or partially. If left untreated, hyphema can go on to cause serious glaucoma. Thus, hyphema requires immediate attention.

Retinal Detachment - It is a common condition found in older populations. As a person ages, the retinal layer at the back of the eye tends to pull away from the back, resulting in retinal detachment.

Retinal detachment can occur because of three reasons, and they are,

• A tear in the retinal layer will cause fluid to pass through it and accumulate underneath. Thus, making the retina detached.

• Not a tear, but an inflammatory condition, injury to the eye, or age-related macular degeneration can cause fluid accumulation and result in retinal detachment.

• People with uncontrolled diabetes are more prone to developing scar tissue over the retinal layer. The scar tissue will cause the retinal to pull away from the back of the eye, causing retinal detachment.

It is an emergency condition requiring immediate ophthalmologist’s attention to prevent complications like permanent vision loss.

Foreign Bodies in the Eye - Entrapment of foreign objects like dirt, shattered glass, or dust can cause eye injury. Even prolonged use of contact lenses can cause eye injuries.

What Are the Common Symptoms of Ocular Trauma?

The common signs and symptoms of ocular trauma are,

• Pain and swelling are common signs of an eye injury.

• Redness of the eye.

• Changes in vision can occur. Blurred vision, flashes of light, and floaters in the path of vision are seen commonly.

• A red spot in the white area of the eye (sclera) is a bleeding condition and a typical sign of an eye injury.

• Few people may present with crossed eyes (strabismus) or a protruded eye socket. Even the size of the pupil can be abnormal.

• Few patients will have restricted eye movements.

How to Diagnose an Ocular Trauma?

The doctor will begin by evaluating the signs and symptoms. Will check for the abnormalities and presence of foreign objects in the eye. A special light instrument will be used to dilate the pupil and study the inner layers of the eye precisely. In case of severe issues, doctors may advise the patient to get a computed tomography (CT) scan and magnetic resonance imaging (MRI) scan done to study the soft tissue injuries and fractures of the eye.

What Are the Various Ways to Treat Ocular Trauma?

• Cold compresses are used to treat the pain and swelling in case of an eye injury.

• In case of chemical burns or entrapment of foreign bodies, flushing off with clean water is mandatory.

• A doctor will prescribe eye drops to heal the condition.

• Eye patches will be recommended for better healing.

• Surgical intervention to fix the broken bones will be needed in case of orbital fractures.

How to Prevent Ocular Trauma?

• Protective glasses or goggles should be worn while playing sports activities and handling chemicals .

• Avoid laser pointer contact with the eyes.

• Hazardous chemicals should be stored safely, away from children’s reach.

• Educating the general public about the various sources of eye injuries and the necessity to be careful while handling hazardous substances.

Conclusion

The severity of the ocular trauma will depend on various factors. Necessary precautions should be taken to avoid ocular trauma. If exposed to an injury beyond all preventive measures, immediate medical care should be taken to prevent further complications.