Ocular Injuries

A typical history is that, while hammering a metal object a foreign body hits the eye, or a sharp object, for example, a piece of broken glass stabs the eye. An irritating or corrosive substance in the eye is treated by irrigating the eye immediately at the site of the accident, or if this has not been done, as soon as the patient arrives, for at least ten minutes, preferably 30 minutes (or even 60 minutes if the substance was alkaline. Tear gas is best expelled from the eye by ventilating with flowing air for at least ten minutes. Examine the eye with a magnifying glass and fluorescein. In cases of eyelid injuries, immediately refer patients with injuries interrupting the lid margin and patients with a deep lid injury. In a patient with a ball or fist hitting the eye check the pupillary reactions, eye movements, ocular fundus, intraocular pressure, and sense of touch in the lower lid. If the patient does not have diplopia, the anterior chamber looks clear, the visual acuity is not impaired, and the pupillary reactions are normal, the patient does not need a referral.

 

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