Summary
Definition
History and exam
Key diagnostic factors
- hifema
- equimose
- dor intensa no olho
- visão turva
- abrasões da córnea
- edema da córnea
- hemorragias subconjuntivais
- lacerações da córnea e da conjuntiva
- erosões epiteliais pontuadas
- perda da visão
Other diagnostic factors
- lacrimejamento excessivo
- quemose conjuntival
- hiperemia conjuntival
- abrasão/defeito epitelial da córnea
- lesão ocular aberta
- queimaduras das pálpebras
- fotofobia
- diplopia
- miose
- opacificação do estroma da córnea
- iridodiálise
- corpo estranho conjuntival
- corpo estranho na córnea
- lacerações da membrana de Descemet
- lacerações corneosclerais
- cefaleia persistente
- perda de consciência
- sangue ou fluido claro dos ouvidos ou nariz
- incapacidade de mover o(s) olho(s)
Risk factors
- idade entre 18-45 anos
- sexo masculino
- ausência de protetores oculares
- lesões ocupacionais
- quedas
- fogos de artifício
- exposição à luz ultravioleta
- cirurgia prévia do olho
- antissépticos para as mãos à base de álcool
Diagnostic investigations
1st investigations to order
- TC da órbita
- tomografia computadorizada (TC) craniana
- ressonância nuclear magnética (RNM) de crânio
Investigations to consider
- radiografia simples
- ultrassonografia modo B
- biomicroscopia ultrassônica
- tomografia de coerência óptica
- angiografia fluoresceínica
- autofluorescência de fundo do olho
- exame de urina para detecção de drogas
- exame de traço falciforme
Treatment algorithm
lesões superficiais sem corpo estranho
hifema
abrasão da córnea
lesão ocular aberta
erosões da córnea recorrentes ou má recuperação
Contributors
Authors
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
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
ERR declares that she has no competing interests.
Peer reviewers
Yewlin E. Chee, MD
Assistant Professor of Ophthalmology
University of Washington
Seattle
WA
Disclosures
YE declares that she has no competing interests.
Andrew W. Eller, MD
Professor of Ophthalmology
University of Pittsburgh School of Medicine
Pittsburgh
PA
Disclosures
AE declares that he has no competing interests.
Saloni Kapoor, MD
Clinical Assistant Professor of Medicine
UPMC Mercy Hospital
Pittsburgh
PA
Disclosures
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
Disclosures
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.
References
Key articles
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. Abstract
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. Abstract
MacEwen CJ. Ocular injuries. J R Coll Surg Edinb. 1999 Oct;44(5):317-23. Abstract
American Academy of Ophthalmology. Policy statement: referral of persons with possible eye diseases or injury. Apr 2014 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Guidelines
- Pediatric eye evaluations preferred practice pattern
- RCH clinical practice guidelines: acute eye injury
More Guidelines
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