WARNING !

The  images below are

graphic, and may be

repulsive to some.

Open eye trauma

Penetrating eye injury requires immediate referral to an eye specialist

because of the risk of devasting ocular infection.

Presentation:

• Most commonly seen in children at play with sharp object

• Shattered windshield in road traffic accidents

• High velocity projectiles (missles) at work place

Examination:

• Visual acuity is reduced due to cornea distortion or blood

• Most injuries involves the cornea or at the corneoscleral junctions.

• Therefore displacement 
  of the iris or pupil should alert the possibility of open eye injury.

Management:

• Refer the patient immediately to the eye casualty specialist.

Figure 1.
This patient sustained a left peforating eye injury when his friend threw him a 
sharp pencil at school. The visual acuity was hand movement. Note the 
displacement of the iris and pupil towards 8 O'clock where the perforation 
occurs at the corneoslceral junction. He was admitted for wound repair and 
was given antibiotic cover. The eventual visual acuity was 6/12 with glasses.

Figure 2.
Another patient with a penetrating injury. 
Note the iris prolapse and the "tear drop" shape iris. It is 
important to exclude the presence of intraocular foreign body.

Figure 3.
This man sustained a right corneal laceration in a road traffic 
accident from a broken windshield. The picture shows the 
cornea immediately following primary repair.