Bruised eyes: symptoms and treatment

Eye contusion, or eye contusion( second name) is the most frequent type of eye injury caused by a direct blow or explosion.Despite the fact that this is the easiest type of damage, 33% of the victims lose their sight completely.Hence the increased attention to this pathology.

Table of contents:

Types of eye injury

The main clinical classification divides the eye contusions according to the severity of :

• is easy;
• medium-heavy;
• heavy;
• is especially heavy.

The mild degree of is accompanied by hemorrhages under the skin of the peri-ocular area and conjunctiva, equal and / or bruised skin wound of eyelids and conjunctiva, slight edema and erosion of the cornea, muscle spasm of the lens, reversible clouding of the retina( "Berlin").

The contusion of moderate severity is characterized by the blind corneal wound, its edema, as well as the tearing of the pupillary margin of the iris and the paresis of the muscles of accommodation.

Severe eye contusion - vision is reduced by more than 50%, rupture or separation of the eyelids, sclera, irises, opacity or dislocation( sometimes subluxation) of the lens, blood appears in the vitreous, tearing or retinal detachment is possible, optic nerve damage andThe bone wall of the orbit.

With an especially severe contusion of , there is no vision, the eyeball is crushed, the optic nerve in the bone channel is torn, torn off or squashed.

There is another simple classification according to the mechanism of injury:

• a direct contusion occurs due to the impact of the damaging factor directly on the eye and its appendages;
• with indirect contusion, the impact is applied to the surrounding visual organs of the bone structure;In this case, there is no damage to the skin and skin, but internal injuries are possible.

Symptoms of an eye injury

Symptoms of an eye injury should be considered in relation to the anatomical entity of the organ.This is how ophthalmologists study them.

Conjunctival lesion

A light injury can cause minor hemorrhages in the conjunctiva that do not require special treatment.In severe trauma, hemorrhages are significant, increasing in the first day.You should carefully study the organ of vision in order to exclude the subconjunctival rupture of the sclera.If it is found, surgical suturing is required.

Corneal damage

Mild damage to the cornea is accompanied by increased lacrimation, photophobia, cuts in the damaged eye, spasm of the eyelids.In severe contusions, corneal reflexes decrease, and its turbidity arises.

Scleral damage

Indirect signs indicate its discontinuity:

• decreased intraocular pressure;
• decreased vision;
• hemophthalmus( blood in the vitreous humor);
• changes the depth of the anterior chamber of the eye;
• with diaphanoscopy - a bright pink glow in the rupture zone.

This type of damage most often leads to a complete loss of vision.

Damage to the iris

With a mild degree of trauma, there is miosis( persistent constriction of the pupil), which occurs after 2-3 days.The severe form of the injury is accompanied by a detachment of the iris in the area of ​​its root, a paralytic mydriasis( persistent dilatation of the pupil). Sometimes the iris can completely come off.

Damage to the ciliary body

The most frequent consequence of damage to the ciliary body is iridocyclitis. In severe trauma, detachment of this part of the eye is possible with the appearance of characteristic signs:

1. intraocular hypotension;
2. reduced front camera size;
3. detachment of the choroid.

Damage to the lens

Possible dislocation, subluxation, rupture of the lens.After an injury over time, cataracts can develop.

Vitreous Damage

The main symptom is hemophthalmus, which causes a decrease in vision.When examined inside the eye, the blood looks like threads, flakes, drops, dots.

Damage of the fundus

Here, with trauma, there are many signs that are visible in the examination:

• hemorrhages, opacities and ruptures of the retina;
• rupture of the choroid;
• chorioretinitis;
• neuroretinopathy;
• retinal detachment;
• chorioretinal dystrophy;
• atrophy of the optic nerve.

In parallel with these signs, there are also symptoms of damage to the peri-ocular structures - bruises( bruises) around the eye, eyelid edema, pain.Symptoms are all the more pronounced, the stronger the stroke and the more structures involved in the pathological process.

Diagnosis

The diagnosis of an eye injury is not in doubt if the circumstances of the injury are known. To clarify the degree of damage, the

• visometry is used to determine visual acuity;
• biomicroscopy, in which changes in the structure of the organ of vision are revealed;
• ophthalmoscopy, which allows a thorough examination of the fundus;
• gonioscopy, which shows damage to the anterior chamber of the eye;
• radiograph of the facial skull for the purpose of identifying fractures of bones;
• Ultrasound, which provides information on the state of the eye( especially important when the transparency of internal environments is violated);
• computer and magnetic resonance imaging, which allow to obtain data on damage to intracranial structures.

Treatment

First aid for any severity of the eye contusion is to apply one of the antibiotics to the eye of the cold and instillation( instillation): ciprofloxacin, ofloxacin, tobramycin.Sulfacil sodium can be used, remembering that it causes severe burning( it is undesirable to use it to treat a child).After this, cover the injured eye with a sterile gauze dressing.

Anyone injured with a bruised eye should be hospitalized in the profile department. After consultation of an ophthalmologist, the following treatment methods can be used:

1. Medicated;

• non-steroidal anti-inflammatory agents;
• desensitizing agents;
• tranquilizers;
• antibiotics;
• antiseptics;
• mydriatica( drugs dilating the pupil);
• stimulators of regeneration.

1. Surgical, consisting in the revision of wounds and injuries and their elimination.

Eye injury is a serious injury.Even with a light attack, damage to the intraocular structures is possible, which without immediate treatment can lead to loss of vision.Therefore, self-medication with concussion is completely unacceptable.

Bozbey Gennady Andreevich, ambulance doctor