Eye trauma

Last reviewed: 24 Feb 2023
Last updated: 03 Oct 2019

Summary

Definition

History and exam

Key diagnostic factors

  • hyphema
  • ecchymosis
  • severe eye pain
  • blurred vision
  • corneal abrasions
  • corneal edema
  • subconjunctival hemorrhages
  • conjunctival lacerations
  • punctate epithelial erosions
  • loss of sight
More key diagnostic factors

Other diagnostic factors

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

Risk factors

  • age 18-45 years
  • male sex
  • no protective eyewear
  • workplace injuries
  • fireworks
  • exposure to ultraviolet light
  • previous eye surgery
More risk factors

Diagnostic investigations

1st investigations to order

  • CT scan of head and orbit
More 1st investigations to order

Investigations to consider

  • plain x-ray
  • B-scan ultrasonography
  • ultrasound biomicroscopy
  • MRI scan of head
  • optical coherence tomography
  • fluorescein angiography
  • fundus autofluorescence
  • urine drug screen
  • sickle cell trait screen
More investigations to consider

Treatment algorithm

ACUTE

superficial injuries without a foreign body

hyphema

corneal abrasion

open globe injury

ONGOING

recurrent corneal erosions

Contributors

Authors

Fasika Woreta, MD, MPH

Assistant Professor of Ophthalmology

Residency Program Director

Director, Eye Trauma Center

Wilmer Eye Institute

Johns Hopkins University School of Medicine

Baltimore

MD

Disclosures

FW declares that she has no competing interests.

Acknowledgements

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

Disclosures

RA is an author of a reference cited in this topic. ERR declares that she has no competing interests.

Peer reviewers

Patricia Pahk, MD

Assistant Professor of Ophthalmology

Mount Sinai Medical School

New York

NY

Disclosures

PP is an author of a reference cited in this topic.

Scott Fraser, MD, FRCS (Ed), FRCOphth

Consultant Ophthalmologist

Sunderland Eye Infirmary

Sunderland

UK

Disclosures

SF declares that he has no competing interests.

David Allen, MD

Consultant Ophthalmologist

Sunderland Eye Infirmary

Newcastle

UK

Disclosures

DA declares that he has no competing interests.

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