(See also Retinal Disorders: Retinal Detachment.)
Common causes of eye injury include domestic accidents (eg, during hammering or exposure to household chemicals or cleaners), assault, car battery explosions, sporting injuries (including air- or paint pellet-gun injuries), and motor vehicle crashes (including airbag injuries). Injury may be to the eyeball (globe), surrounding soft tissues (including muscles, nerves, and tendons), or bones of the orbit.
General evaluation should include the following:
Detailed examination of the sclera, anterior segment (cornea, anterior chamber, ciliary body, iris), lens, and anterior vitreous is best done with a slit lamp. Although direct ophthalmoscopy can be used to examine the lens and posterior structures of the eye, indirect ophthalmoscopy, usually done by an ophthalmologist, provides a more detailed view of these structures. Indications for indirect ophthalmoscopy include clinical suspicion of traumatic cataracts, vitreous abnormalities (eg, hemorrhage, foreign body), and retinal abnormalities; clinical suspicion may be based on injury mechanism, absence of the red reflex, or retinal abnormalities (visible with direct ophthalmoscopy). Because direct and indirect ophthalmoscopy are best done through a dilated pupil, about 15 to 30 min before this examination, mydriatics (such as 1 drop of cyclopentolate 1% and 1 drop of phenylephrine 2.5%) can be instilled. If an intraocular or orbital foreign body or an orbital fracture is suspected, CT is done.
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.
When eye drops are prescribed, each dose includes only one drop.
Last full review/revision September 2012 by Kathryn Colby, MD, PhD