This document provides guidance on evaluating and treating common types of ocular trauma. It describes important questions to ask patients regarding their medical history and details of the trauma. Examination of the external eye and potential signs of injury are outlined. Treatment recommendations are provided for removing foreign objects from the eye, managing blunt eye trauma from blows or objects, penetrating injuries, and chemical burns. Immediate irrigation with water and seeking prompt medical care are consistently emphasized.

2. AHMED FOUAD MAHMOUDAHMED FOUAD MAHMOUD
OPHTHALMOLOGISTOPHTHALMOLOGIST
MGHMGH

4. OCULAR
TRAUMA

5. History-Questions to askHistory-Questions to ask
 Onset, durationOnset, duration
 Patient’s occupationPatient’s occupation
 Exposure toExposure to
chemicals, UV light,chemicals, UV light,
cosmetics, etccosmetics, etc
 Trauma, foreign body,Trauma, foreign body,
contact lenscontact lens
 Type of painType of pain
 PhotophobiaPhotophobia
 Exudate?Exudate?
 Systemic symptoms-Systemic symptoms-
fever, N/V, rash,fever, N/V, rash,
arthritisarthritis
 Past medical history-Past medical history-
DM, HIV, collagenDM, HIV, collagen
vasc disease, HTN,vasc disease, HTN,
glaucoma, eyeglaucoma, eye
surgerysurgery

6. EXTERNAL EYEEXTERNAL EYE
Examine periorbital skin andExamine periorbital skin and
lids forlids for::
TraumaTrauma
InfectionInfection
DysfunctionDysfunction
DeformityDeformity
CrepitusCrepitus
ProptosisProptosis
Subcutaneous emphysemaSubcutaneous emphysema

9. FOREIGN OBJECTSFOREIGN OBJECTS
 dustdust
 dirtdirt
 metalmetal
 splintersplinter
 rustrust
 pens/pencilspens/pencils
 glass, etc.glass, etc.

11. TREATMENTTREATMENT
FOREIGN OBJECTSFOREIGN OBJECTS DO NOT rub the eyeDO NOT rub the eye
 flush eye with tepid water from innerflush eye with tepid water from inner
corner to outer corner of eye untilcorner to outer corner of eye until
object is freeobject is free (use gentle water flow)(use gentle water flow)
 may invert eyelid onto Q-tip, andmay invert eyelid onto Q-tip, and
gently flush objectgently flush object
 if still in, close both eyes & seekif still in, close both eyes & seek
medical attentionmedical attention
 keep patient informed as they can’tkeep patient informed as they can’t
seesee

13. EYE INJURIESEYE INJURIES
 CAUSES OF BLUNTCAUSES OF BLUNT
EYE TRAUMA:EYE TRAUMA:
 fists (altercations)fists (altercations)
 snowballssnowballs
 baseballs/softballsbaseballs/softballs
 doors, etc.doors, etc.

17. Orbital Wall FractureOrbital Wall Fracture

21. algorithm

30. Vitreous HemorrhageVitreous Hemorrhage

31. Retinal HemorrhageRetinal Hemorrhage

32. Optic Disc HemorrhageOptic Disc Hemorrhage

36. TREATMENTTREATMENT
BLUNT EYE TRUAMABLUNT EYE TRUAMA
 have victim sit semi-uprighthave victim sit semi-upright
 close both eyesclose both eyes
 seek medical attentionseek medical attention
immediatelyimmediately
 DODO NOTNOT place any weight ontoplace any weight onto
globe of eyeglobe of eye
 DODO NOTNOT place ice on the eyeplace ice on the eye

39. PENETRATINGPENETRATING
EYE INJURIESEYE INJURIES
 CAUSES :CAUSES :
 penspens
 ice picksice picks
 knivesknives
 bulletsbullets
 roofing staplesroofing staples
 pool sticks, etc.pool sticks, etc.
staple

47. TREATMENTTREATMENT
PENETRATING EYEPENETRATING EYE
 place victim inplace victim in semi-sittingsemi-sitting
positionposition
 closeclose both eyesboth eyes of victimof victim
 NO pressureNO pressure on the eyeon the eye
 dry gauze pads over both eyesdry gauze pads over both eyes
 seek medical attentionseek medical attention
immediatelyimmediately
 victimvictim can’t seecan’t see when both eyeswhen both eyes
are covered, keep themare covered, keep them

49. CHEMICAL BURNSCHEMICAL BURNS
 AcidAcid
 destroys eye withindestroys eye within
30 min. & appears30 min. & appears
“beefy red”“beefy red”
 flush immediatelyflush immediately
with tepid, gentlewith tepid, gentle
flow water, fromflow water, from
inner to outerinner to outer
corner of eye 20corner of eye 20
minutes minimumminutes minimum
 AlkaliAlkali
 destroys eye indestroys eye in
30 seconds &30 seconds &
appearsappears “milky“milky
white”white”
 flush immediatelyflush immediately
with tepid, gentlewith tepid, gentle
flow water, fromflow water, from
inner to outerinner to outer
corner of eye 20corner of eye 20
minutes minimumminutes minimum