Eye injuries are a very common cause of hospital emergency room visits. While things like soap or dust in the eyes, or a bump or poke, are minor injuries that can be treated at home, sometimes there are much more serious incidents or accidents that require professional medical attention. Eye trauma should always be full assessed as any penetrating injury can put the patient at risk of losing their sight, either through the trauma itself or a subsequent infection.
When you arrive at the emergency room following your accident or injury, one of the first things that you will be asked is to give a detailed, accurate history with regards to how the trauma occurred. This is extremely important as it helps to understand the potential complications that may arise as a result of the trauma. For example, if there is any high-velocity impact it significantly raises the chance of a penetrating injury. Blunt force injuries such as a punch raise the chance of a blowout injury.
If you arrive at the emergency room and are unable to recall the nature of your accident or injury, then you will be given a full assessment of every possibility to exclude the need for emergency action.
You can expect to be asked:
- How long since the accident/injury occurred?
- The circumstances surrounding the injury, including:
· What you were doing at the time the injury occurred
· Whether glasses, contacts or any other eyewear (goggles) were worn at the time of the incident
- The mode of injury, including:
· Whether it was physical, chemical or thermal
· The speed with which the eye was impacted
· The nature and size of the object involved (sharp/blunt/large/small)
· Whether you may still have a foreign body in the eye
- Any other injuries that you may have sustained
- What treatment you have applied so far (eye bath/compress etc) if applicable
- Current symptoms related to vision, for example: floaters, reduced vision, flashing, pain, sensation of a foreign body etc
- Information on your vision prior to the incident, such as whether you wear glasses for long/short-sightedness.
- Your general medical history including current medication, previous operations and allergies.
You will be given a thorough examination which will be dictated by your ability to co-operate (some patients may be in extreme pain, confused, or even unconscious). At this point it is important to remember that the level of pain you feel or the current impact on your visual ability does not necessarily correlate with the severity of your injury. Many eye injuries may look and feel a lot worse than they actually are.
If your emergency room doctor feels it is necessary, he/she may make an emergency referral to an ophthalmologist. Reasons for this may include:
- A chemical burn
- A confirmed or suspected ‘open globe’ (penetrating) injury
- Suspected retinal injury
- Deep lid lacerations
- Pupil, iris or fundal abnormalities
- A foreign body that cannot be removed
- Corneal opacities, rust rings or large corneal abrasions
If your injury requires further investigation, then you will probably be given a CT scan as this is the first choice for evaluating eye trauma and detecting open globe injuries.