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Eye trauma

最后审阅: 18 Aug 2025
最后更新: 30 Oct 2024

小结

定义

病史和体格检查

关键诊断因素

  • hyphaema
  • ecchymosis
  • severe eye pain
  • blurred vision
  • corneal abrasions
  • corneal oedema
  • sub-conjunctival haemorrhages
  • corneal and conjunctival lacerations
  • punctate epithelial erosions
  • loss of sight
完整详情

其他诊断因素

  • excessive lacrimation
  • conjunctival chemosis
  • conjunctival hyperaemia
  • corneal epithelial defect/abrasion
  • open globe injury
  • eyelid burns
  • photophobia
  • diplopia
  • miosis
  • corneal stromal clouding
  • iridodialysis
  • conjunctival foreign body
  • corneal foreign body
  • Descemet's membrane tears
  • corneoscleral lacerations
  • persistent headache
  • loss of consciousness
  • blood or clear fluid from ears or nose
  • inability to move eye(s)
完整详情

危险因素

  • age 18-45 years
  • male sex
  • no protective eyewear
  • workplace injuries
  • falls
  • fireworks
  • exposure to ultraviolet light
  • previous eye surgery
  • alcohol-based hand sanitisers
完整详情

诊断性检查

首要检查

  • CT scan of orbit
  • CT scan of head
  • MRI scan of head
完整详情

需考虑的检查

  • plain x-ray
  • B-scan ultrasonography
  • ultrasound biomicroscopy
  • optical coherence tomography
  • fluorescein angiography
  • fundus autofluorescence
  • urine drug screen
  • sickle cell trait screen
完整详情

治疗流程

急症处理

superficial injuries without a foreign body

hyphaema

corneal abrasion

open globe injury

持续性治疗

recurrent corneal erosions or poor healing

撰稿人

作者

Fasika Woreta, MD, MPH

Associate Professor of Ophthalmology

Residency Program Director

Director, Eye Trauma Center

Wilmer Eye Institute

Johns Hopkins University School of Medicine

Baltimore

MD

利益声明

FW declares that she has no competing interests.

鸣谢

Dr Fasika Woreta wishes to gratefully acknowledge Dr Ron Adelman and Dr Elena Raluca Raducu, previous contributors to this topic.

利益声明

ERR declares that she has no competing interests.

同行评议者

Yewlin E. Chee, MD

Assistant Professor of Ophthalmology

University of Washington

Seattle

WA

利益声明

YE declares that she has no competing interests.

Andrew W. Eller, MD

Professor of Ophthalmology

University of Pittsburgh School of Medicine

Pittsburgh

PA

利益声明

AE declares that he has no competing interests.

Saloni Kapoor, MD

Clinical Assistant Professor of Medicine

UPMC Mercy Hospital

Pittsburgh

PA

利益声明

SK declares that she has no competing interests.

Seanna Grob, MD, MAS

Assistant Professor of Ophthalmology

Oculoplastic Surgeon

University of California San Francisco

San Francisco

CA

利益声明

SG has written a book on ocular trauma.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Kuhn F, Mester V, Berta A, et al. Epidemiology of severe eye injuries: the United States Eye Injury Registry (USEIR) and the Hungarian Eye Injury Registry (HEIR) [in German]. Ophthalmologe. 1998 May;95(5):332-43. 摘要

Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am. 2002 Jun;15(2):139-43. 摘要

MacEwen CJ. Ocular injuries. J R Coll Surg Edinb. 1999 Oct;44(5):317-23. 摘要

American Academy of Ophthalmology​. Policy statement: referral of persons with possible eye diseases or injury. Apr 2014 [internet publication].全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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