injuries poisoning
Eye Contusions and Lacerations
Key Points
Consult an ophthalmologist if an eyelid laceration is complicated (eg, through the margin, tarsal plate, or canaliculus, causing ptosis, or exposing orbital fat). Globe trauma may cause globe laceration, cataract, lens dislocation, glaucoma, vitreous hemorrhage, or retinal damage (hemorrhage, detachment, or edema). Suspect globe rupture if trauma results in a visible corneal or scleral laceration, leaking aqueous humor, an unusually shallow or deep anterior chamber, or an irregular pupil. Hyphema, best diagnosed by slit-lamp examination, requires bed rest with head elevation at 30 to 45° and close monitoring of intraocular pressure. Refer patients for surgical repair of blowout fractures that cause diplopia or unacceptable enophthalmos. Do immediate lateral canthotomy on patients with orbital compartment syndrome. 