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The structure of the face and eyes is well suited for protecting the eyes from injury. The eyeball is set into the orbit, a socket surrounded by a strong, bony ridge. The eyelids close quickly to form a barrier to foreign objects, and the eye can tolerate minor impact without damage. Because of these protective features, many eye injuries do not affect the eyeball and are thus not dangerous, even though extensive bruising and swelling to surrounding structures may make them look worse than they are. However, injury occasionally damages the eye so severely that vision is affected and sometimes completely lost. In rare instances, the eye must be removed.
Causes
Common causes of eye injury include domestic or industrial accidents (for instance, from using a hammer or liquid chemicals or cleaners), assault, car battery explosions, sports injuries (including air-gun or paint pellet-gun injuries), and motor vehicle collisions (including air-bag injuries). Exposure to strong ultraviolet light, as from a welding arc or bright sunlight reflected off snow, can injure the transparent dome on the front surface of the eye (cornea—see Corneal Disorders: Superficial Punctate Keratitis).
Evaluation
A person with an eye injury should be examined by a doctor. Glasses (if worn) should be brought so that the person's vision can be assessed with their normal correction—this can help the doctor know whether any abnormal vision is a new problem or an old one.
The eye examination may include a slit-lamp examination (see Diagnosis of Eye Disorders: Slit-Lamp Examination) and ophthalmoscopy (see Diagnosis of Eye Disorders: Ophthalmoscopy). The slit lamp contains a light, an adjustable binocular magnifying instrument, and a table that adjusts the position of these components. A slit-lamp examination assesses mainly the front of the eye, particularly the eye surface and eyelid. Ophthalmoscopy assesses mainly the back of the eye. Often, ophthalmoscopy is done after the eye is dilated with eye drops such as cyclopentolate and phenylephrine. After dilation, more of the eye can be seen, particularly the retina.
If the injury is serious, particularly if the vision is affected, the doctor who first examines the person arranges for an ophthalmologist (a medical doctor who specializes in eye disorders) to evaluate and treat the person.
Prevention
Use of eye guards, goggles, or special eyeglasses, such as those constructed of polycarbonate lenses in a wrap-around polyamide frame, is a simple precaution that greatly reduces the risk of injury.
Last full review/revision January 2013 by Kathryn Colby, MD, PhD
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