injuries and poisoning
Eyelid and Eyeball Lacerations
Eyeball Laceration
Of those lacerations that affect the eyeball, many are superficial. However, some cuts go through the white of the eye (sclera) or the transparent dome on the front surface of the eye (cornea), penetrating the eye’s interior. Such cuts are considered a rupture of the eyeball (globe). The globe also can be ruptured by a blunt force. Most people with a ruptured globe have decreased vision. The eye is often obviously distorted, and the pupil may be shaped like a teardrop. Sometimes fluid leaks out of the eye. Excessive bleeding under the conjunctiva (the thin mucous membrane that covers the cornea) is sometimes a symptom of a ruptured globe. Eyeball lacerations can seriously damage the structures necessary for vision and make eyeball infection ( Endophthalmitis ) more likely. An ophthalmologist's evaluation Computed tomography (CT) A laceration to the eyeball requires an immediate evaluation by an ophthalmologist (a medical doctor who specializes in the evaluation and treatment—surgical and nonsurgical—of eye disorders). CT is done to confirm the diagnosis and see if any foreign material is inside the eye or if there is other damage around the eye. eye becomes inflamed ( Sympathetic Ophthalmia ), which may result in partial loss of vision or even blindness if left untreated. Often, corticosteroid drops can effectively treat this reaction. Doctors may remove an irreversibly damaged eye with no vision to prevent sympathetic ophthalmia. Surgery Surgical repair is often necessary for eyeball lacerations, except for some injuries that affect only a small area of the thin mucous membrane that covers the cornea (conjunctiva). Even before surgery, antibiotics are given by vein (intravenously) to reduce the chance of infection within the eye. Ointments should be avoided. A protective shield (either a commercial product or the bottom part of a paper cup) is taped over the eye to avoid unintentional pressure that could force the contents of the eye through the laceration. If any foreign body protrudes from the eyeball or around the eyeball, it should be left in place until an ophthalmologist can see the person. Drugs for pain are given by vein or, if surgical repair is not needed, by mouth. If necessary, vomiting can be controlled with drugs that relieve nausea. A Vaccination is given as soon as possible. 