BLUNT INJURIES

A blunt object striking the eye with great force may result in minor or severe injury to the eye.

Different structures of the eye maybe involved.

Clinical features

ANATOMINAL
STRUCTURE
INVOLVED
CLINICAL FEATURES
Lids, cornea, and
the conjunctiva
Eyelid swelling and subcutaneous
bleeding. The degree of swelling
may be mild to severe. There may be
corneal abrasions and conjunctival
swelling and sub conjunctival
haemorrhages
Anterior chamber,
lens, vitreous or
retina
Decreased visual acuity is an
indication that the injury involved
either the anterior chamber, lens,
vitreous, or retina.

All the above will result in poor
vision and are potentially blinding
conditions.

Orbital bones A blunt injury may cause orbital
bone fractures. The commonest is a
fracture of the ethmoid bone.
The patient may present with
swelling of the eye and proptosis if
there is haemorrhage in the orbit
or a sunken or retracted eyeball
depending on the site of the fracture.
The patient may also complain of
double vision (Diplopia

MANAGEMENT

  • Assess the visual acuity, and if this is normal and there are no signs/symptoms of orbital bone
    fracture give:

    • Gentamicin or chloramphenicol eye drops or tetracycline eye ointment
    • Pain reliever – Paracetamol
    • A cold compress maybe helpful in lid swelling
  • If the visual acuity is poor, pad the eye, give a pan reliever and REFER URGENTLY THE PATIENT
    TO A SPECIALIST as this is an indication of injury to deeper structures