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Open eye trauma

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Penetrating eye injury requires immediate referral because of the risk of devasting ocular infection.

Presentation:

  • Most commonly seen in children at play with sharp object
  • Shattered windscreen in road traffic accidents
  • High velocity missles at work place
Examination:
  • Visual acuity is reduced due to cornea distortion or blood
  • Most injuries involves the cornea or at the corneoscleral junctions. Therefore displacement 

  • of the iris or pupil should alert the possibility of open eye injury.
Management:
  • Refer the patient immediately to the eye casualty
Figure 1.
This patient sustained a left peforating eye injury when his friend threw him a 
sharp pencil at school. The visual acuity was hand movement. Note the 
displacement of the iris and pupil towards 8 O'clock where the perforation 
occurs at the corneoslceral junction. He was admitted for wound repair and 
was given antibiotic cover. The eventual visual acuity was 6/12 with glasses.

Figure 2.
Another patient with a penetrating injury. 
Note the iris prolapse and the "tear drop" shape iris. It is 
important to exclude the presence of intraocular foreign body.

Figure 3.
This man sustained a right corneal laceration in a road traffic 
accident from a broken windscreen. The picture shows the 
cornea immediately following primary repair. See trauma for 
the management of eye trauma. 

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