special subjects
Work Related Eye Injuries
Diagnosis of Work Related Eye Injuries
Detailed description of the accident Examination, includingfluoresceinstaining and slit-lamp examination For suspected fractures or radiopaque foreign bodies, x-rays of the orbit The evaluation of work-related eye injury is similar to Overview of Eye Trauma . Evaluation can be difficult when massive lid edema or laceration is present. Determining which specific job task and exactly what the patient was doing when injured is essential to making a correct diagnosis. Tasks involving grinding and cutting of metal using a high-speed wheel, drilling apparatus, or chisel produce extremely small metal (or other material) fragments that may be projected into the air at high speed. If workers are not wearing appropriate eye protection, these fragments may penetrate the globe, and the entrance wound may not be easily seen during gross inspection. Consequently, all injuries involving high-speed metal fragments (and all workplace eye injuries) must be promptly evaluated usingfluoresceinstaining and slit-lamp examination done by a physician skilled in this examination. Plain x-rays of the orbit may help identify metallic foreign bodies in the globe, as well as bone and/or sinus injury. MRI should be avoided if an intraocular metal fragment is suspected. CT may be helpful pre-operatively at the option of the eye surgeon. If globe laceration with or without foreign bodies is suspected, prompt ophthalmology consultation is essential. Findings that suggest Orbital compartment syndrome include vision loss, diplopia, proptosis. ophthalmoplegia, and elevated intraocular pressure. Eye Contusions and Lacerations of the lids and lid margins should be identified and referred to an appropriate specialist surgeon for repair. For chemical eye injuries, physicians must identify the chemical and its physicochemical properties, which are listed on the relevant Safety Data Sheet, available from the worksite. The concentration of the chemical and duration of exposure must also be identified. Although superficial uncomplicated corneal abrasions may be followed up by family practitioners or in the emergency department, all work-related eye injuries should be considered for ophthalmology follow up. Injuries that require immediate ophthalmology consultation include those with corneal opacification or sloughing, conjunctival blanching, lid lacerations, and orbital compartment syndrome. 