This document discusses various types of eye trauma including open globe injuries, closed globe injuries, and injuries to specific structures within the eye. It provides details on blunt and penetrating trauma, complications like sympathetic ophthalmia, investigations like water's view, and foreign bodies involving metals like iron and copper. Trauma can cause injuries to the cornea, iris, lens, retina, and other structures and may lead to complications such as cataracts, glaucoma, or phthisis bulbi if not properly treated.

1. Trauma to eye

3. Open globe injury Closed globe injury
Injury with out full thickness defect of coats ocular injury without a full-thickness
defect of the coats
Contusion Lamellar laceration Rupture Laceration
Injury d/t blunt trauma Partial thickness wound of coats
d/t sharp object or blunt
trauma
Rupture of the
sclera is an open-
globe
injury occurring
from inside
outwards. This is
generally
due to its being
suddenly and
violently forced
against
the orbital walls
penetrating injury perforating injury Intraocular
retained
foreign body
if the object
traverses the coats only
once
if both an entry
and exit wound are
present,

5. Closed globe injury by blunt
trauma

6. Closed globe injury by blunt trauma
Cornea Sclera Iris & ciliary body Lens
• Corneal abrasion
• Corneal opacity
• Blood staining of
cornea
• Rupture of globe
• Intraocualr
haemorrhage
• post-traumatic
iridocyclitis
• traumatic miosis due
to irritation of the
nerves occurs initially
in every severe
contusion.
• Traumatic mydriasis
• Iridodialysis
• D shaped pupil
• traumatic aniridia or
irideremia
• Hyphaemia
• angle recession 
glaucoma
• Vossius ring on anterior
capsule
• Traumatic /rosette
shaped concussion
cataract
• Subluxation /
dislocation

7. Closed globe injury by blunt trauma….
Retina Choroid Optic nerve Viteous
• Berlins edema
/commotio reinae
• Traumatic macular
degeneration:macular
cyst or hole
• Retinal tear & retinal
detachment
• traumatic proliferative
chorioretinopathy
secondary to
haemorrhage into
• the vitreous, leading to
traction bands
• Rupture
• Choroidal
haemorrhage
• Choroidal detachment
Optic atrophy • Intravitreal
haemorrhage
• appearance of clouds
of fine pigmentary
opacitiesmost
common occurrence

8. Iridodialysis
Iridodialysis, in which the iris is torn
away from its
ciliary attachment for a variable
distance, occurs more frequently
Iridodialysis
A black biconvex area is seen at
the
periphery, and the pupillary
edge bulges slightly inwards
forming a 'D'-shaped pupil.
'D'-shaped pupil.

10. Vossius ring on anterior capsule
ame diameter as the contracted pupil,
and is due to the impression of the iris
on the lens, produced by the force of
the blow driving the cornea and
iris backwards

11. Rosette cataract

12. Commotio retinae (Berlin oedema)
• milky white cloudiness
• due to oedema appears over
a considerable area at the
• posterior pole which may
sometimes disappear after a
• few days when vision is
usually restored

15. Sympathetic ophthalmitis

16. • Bilateral, granulomatous panuveitis
• Develops following
• Occurs after penetrating trauma, or less frequently following intra ocular
surgery
• 65% of cases occur between 2 weeks and 3 months after injury.
• 90% of cases occur within first year

17. • Injury to ciliary body  sympathetic opthalmitis
• Ciliary body is hence called as dangerous zone of eye

18. • Traumatized eye is referred as the exciting eye
• Fellow eye is sympathizing eye

19. • First symptom  photophobia
• First sign  Retrolental flare
• As inflammation starts in ciliary body

20. Symptoms
• Prodromal symptom in sympathizing eye are:
• Photophobia earliest symptom
• Blurring of vision due to loss of accommodation

21. Signs
Anterior segment Posterior segment
• Red and irritable eye
• Earliest sign – Retrolental flare as inflammation
starts in ciliary body
• Koeppe nodules
• Mutton fat KPs
• Posterior synechiae
• Dalen Fuchs nodules – Small deep, yellow – white
spots scattered through out the fundus. Dalen
Fuchs nodules consist of epithelioid cells between
retinal pigment epithelium and Bruch’s membrane
• Optic nerve head – Oedema
• Sub – retinal oedema

22. Dalen fuchs nodule in sympathetic
opthalmitis
granulomatous deposits b/w retinal
pigment epithelium & Bruchs
membrane

23. • Complications
• 1. Complicated Cataract
• 2. Secondary Glaucoma
• 3. Phthisis bulbi

24. • Treatment :
• Vigorous steroid therapy by all possible routes of administration.
• Immuno suppressive therapy – with chlorambucil, cyclophosphamide or
cyclosporin → in severe steroid resistant cases.
• Enucleation–(NOT Evisceration) within 2 weeks of injury if above treatment
fails.

26. Blow out # of orbit

27. INFERIOR WALL OF ORBIT IS MOST
COMMONLY INJURED IN TRAUMA

28. • Most commonly inferior wall is fractured in its posteromedial part

29. BLOW OUT # OF FLOOR OF ORBIT
• ENOPHTHALMOS
• HERNIATION OF INFERIOR RECTUS MUSCLE  RESTRICTION OF
ELEVATION OF EYEBALL  DIPLOPIA
• INFRAORBITAL ANAESTEHSIA

31. Investigation
• Waters view
• Best view for floor of orbit waters view
• Tear drop sign
• Irregularity of floor of orbit

32. TEAR DROP SIGN
TEAR DROP SIGN

33. # roof of orbit

34. # roof of orbit
• MC type of # of orbit encountered in early child hood
• d/t blunt impact to the brow or forehead

35. Retention of foreign bodies

36. Foreign bodies in eye
• foreign body most likely to penetrate & be retained in eye are minute
chips of iron or chisel
• Accounts for 90 % of fb in industry

37. Siderosis
• Caused by iron foreign body
Iris Lens Retina Secondary OAG
Heterochromia
iridis
• Rusty
deposits of
iron in a ring
shaped
manner
• Cataract
• Pigmentary
degeneratio
n of retina

38. Chalcosis
• Perforating injury to eye
with metal containing Cu
• KF ring
• Sunflower cataract
• Golden plaque @ posterior
pole of retina

39. Kayser Fleisher ring Fleisher ring
In chalcosis / Wilson disease In keratoconus
d/t copper deposition in the Descemet's membrane in
the sclero-corneal junction.
d/t iron deposition at the base of cone of cornea