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JAMA Patient Page
June 5, 2018

Injury Around the Eye

JAMA. 2018;319(21):2244. doi:10.1001/jama.2018.5830

The effects of ocular (eye) trauma depend on the mechanism of injury, and outcomes can range from recovery to irreversible blindness and loss of the eye.

Ocular trauma usually occurs when an object or substance makes contact with the eye. When ocular trauma occurs, it can result in blurry vision, complete loss of vision, pain, and physical disfigurement.

Ocular trauma can generally be categorized as blunt, as when a dull object hits the eye, or lacerating, as when a sharp object hits the eye. Blunt trauma is more common and can result from a variety of causes including falls and motor vehicle crashes, including airbag deployment injuries. Lacerating trauma is usually caused by injury with a sharp object like scissors or a variety of workplace-related injuries. Physical assault is a common cause of both blunt and lacerating trauma.

Structures around the eye can also be damaged from blunt trauma. An orbital fracture is when the bones around the eye are broken. This can result in disturbances of eye movement and, if untreated, can result in double vision and a sunken-in appearance to the eye. Retrobulbar hemorrhage refers to bleeding behind the eye. This is a severe type of orbital hemorrhage that can result in irreversible vision loss if the pressure from the hemorrhage is not relieved emergently.

An open globe occurs when blunt trauma is so severe that the wall of the eye bursts open or when a sharp object pierces the wall of the eye. Open globe injuries are an ocular emergency and are often associated with blurred vision, pain, swelling around the eye, low eye pressure, and irregularities of the iris. When these types of injuries are suspected, it is important not to touch the eye or foreign body and to avoid straining and applying pressure on the eye. Medical care should be sought emergently and surgical repair should occur within 24 hours to prevent an infection and other permanent complications. A shield or even a plastic cup taped over the eye can be used to protect the eye until a medical consultation can be performed.

Seeking Medical Care

Any time ocular trauma results in blurred vision, double vision, pain, and/or light sensitivity, a medical consultation is warranted. In severe forms of trauma and when a ruptured globe is known or suspected, medical care should be sought emergently.

Preventing Ocular Injuries

Protective eyewear is always recommended when playing sports or engaging in activities (workplace or home projects) in which objects may accidentally hit or fly into the eye. Depending on the activity, goggles may be the best way to maximize protection.

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For More Information

To find this and other JAMA Patient Pages, go to the For Patients collection at jamanetworkpatientpages.com. A JAMA Patient Page on eye emergencies was published in the August 15, 2017, issue of JAMA.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
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Article Information

Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: Pieramici DJ. Sports-related eye injuries. JAMA. 2017;318(24):2483-2484. doi:10.1001/jama.2017.1756

Andreotti G, Lange JL, Brundage JF. The nature, incidence, and impact of eye injuries among US military personnel: implications for prevention. Arch Ophthalmol. 2001;119(11):1693-1697. doi:10.1001/archopht.119.11.1693

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