Mechanical injury to the eye treatment. Eye injury. Treatment. Superglue hit the eye

Every person is familiar with the concepts - eye trauma. The organ of vision must be started to heal immediately after injury. Any damage to the inside or outside of the eye is considered an injury.

If a third-party object gets into the eye, it is considered an injury.

All damage to the organ of vision is divided into the ingress of a foreign body into the area of the eye and trauma to the organ. Damage doctors call corneal trauma. In this case, the integrity of the transparent, front part of the shell of the eyeball is violated. Serious concerns are caused by damage to the retina and optic nerve.

Types of injuries

The cornea is most often damaged as a result of the ingress of a foreign body into the eye area. It can be a speck of dust, a speck, a grain of sand, any small object, an insect. If this is a slight violation of the integrity of the organ of vision, it is necessary to rinse the eyes at home, apply a sterile bandage. Corneal health will improve in two weeks.

Injuries are divided into light, medium, severe and very severe. They occur both at home and at work (86.5%). About 90% of men receive severe injuries, most of them are young people under 40. Childhood injuries account for 22%, these are children under 16 years of age.

In addition to domestic, industrial and children's types of injuries, they can be of the nature of sports (when playing sports), agricultural (when repairing equipment), combat (in a situation close to military). A chemical burn occurs when chemicals, household cleaners and detergents, acids, alkalis enter the eye area. The most dangerous burns are alkaline, as the alkali quickly penetrates into the depths of the eye, corroding all tissues.

Thermal burns are possible when firing with hot steam, water, and low temperatures. Radiation damage occurs when exposed to radiation, ultraviolet radiation, infrared rays. Non-penetrating (blunt) injuries are sustained by being hit or bruised by any blunt object. Penetrating injuries affect the deeper layers of the eye organ and have very serious consequences.

For injuries of mild to moderate severity, first aid is provided at home and then visits to a doctor. For more severe injuries, immediate medical attention is required.

Symptoms and Effects

Eye injuries: corneal abrasion

After the ingress of a foreign body without penetration, the following sensations are observed:

scratches are formed on the cornea;
the presence of discomfort in the eye area;
burning sensation;
profuse lacrimation;
surface irritation, eye redness;
sharp pain when moving the eyeball;
violation of visibility, fuzzy objects;
fear of light;
inability to open the eye.

After blunt trauma with impact or injury, there are consequences in the form of:

hemorrhage inside the organ;
detachment of the retinal layers;
the possibility of cataracts;
violation of the integrity of the cornea;
the occurrence of inflammation and the spread of infection;
strong pain;
the level of vision decreases;
the development of edema;
purulent discharge.

After penetrating injuries of the lens, its destruction occurs, the eyeball and adjacent tissues are damaged. When cracks occur, possible fractures of the walls surrounding the orbit, air bubbles fall under the skin of the eyelid. As a result, an increase in the eyelid in volume and the dumping of the eyeball forward.

A more complex complication after penetration is a gust of the optic nerve and separation from the eyeball, compression of the canal where the nerve endings pass, which often leads to complete paralysis of vision.

The development of endophthalmitis, another serious complication after penetrating trauma. This inflammation of the purulent nature of the vitreous body. In 80 cases out of 100, it leads to complete loss of vision.

Another purulent inflammation - panophthalmitis, is a defeat of all layers and components of the eye, quickly moves to the brain. The causative agents of the disease are bacteria - staphylococci.

Sympathetic ophthalmia is an inflammation of a non-purulent nature, slowly proceeding in a healthy eye organ, with damage to the other eye. Usually makes itself felt after 1-2 months after injury. The consequences of burns have 4 stages:

slight erosion on the surface of the cornea of the eye;
the presence of burn vesicles on the skin of the eyelids, a thin film on the conjunctiva, a slight opacity of the cornea;
death of the skin, matte color of the cornea;
skin necrosis, porcelain color of the cornea.

Eye injuries: home treatments, prevention

Mild eye injuries do not require hospitalization

After injury to the organ of vision, long and persistent treatment, recovery and rehabilitation are required. An important point after an eye injury is the provision of first aid on the spot, health and the ability to preserve a full-fledged visual process depend on it.

Methods and ways of help

After injury or trauma to the eyes, do not categorically do:

rub your eyelids, make pressing movements on the eye;
touch with your hands and independently pull out objects sticking out of the eye;
flush eyes with water in case of trauma with penetration;
apply cotton wool as a dressing, except for the presence of bleeding.

Help at home in case of a foreign body is reduced to the following:

Wash your hands with soap and water.
With a movement of your hand, pull the lower eyelid towards you, more often small particles are there.
Carefully remove the foreign object by flushing the eye with water. Neither a scarf nor cotton wool is recommended.
After the procedure, even if the particle has not been removed, drip with any eye drops with antibacterial properties.

In case of contact with chemicals:

To put the patient near the sink with a tap, tilting his head so that the affected eye is lower than the healthy one, the eyes are open.
Rinse eyes and eyelids thoroughly under running water for 20-30 minutes.
If both eyes are affected, then wash them at the same time.

In case of a burn with quicklime, remove the grains with a clean napkin, only then rinse under running water. Water should not be used at first, until the lime has been removed with a dry cloth, as in contact with water, lime gives off heat, and aggressive effects on the eyes will intensify.

After a thermal burn of the eyelids and eyes:

Clean the upper part of the eyelids from contamination, disinfect them with alcohol.
Apply dry cold or regular ice in a plastic bag wrapped in a napkin.
Apply antibacterial eye ointment to the area behind the eyelid.

After eye burns in a solarium with a quartz lamp:

Create darkness in the room, as the eyes are afraid of light.
Apply antibacterial cream to the eyelid area.
Apply dry cold or wrapped ice.
Give the patient a generally accepted analgesic.
For penetration damage and bleeding from the eyes:
Apply antimicrobial eye drops.
Apply a sterile bag.

In the presence of a penetrating foreign body:

If the injury is a large foreign body, so that it does not move, fix it with a paper frame.
Cover the healthy eye with a sterile bandage, excluding the mobility of the eyeballs.
Apply eye drops.

Prevention

Compliance with safety instructions - prevention of eye injuries

To prevent damage and possible injury to the eyes, it is necessary to strictly observe safety precautions. Especially when using cutting and piercing objects. Wear safety glasses when working with power tools (grinder, electric plane, drill, grinder, etc.).

Use a special mask or goggles when welding parts. Protect face with a mask when playing with bouncing objects (hockey, baseball, paintball). Wear protective goggles while skiing, exclude direct exposure to the sun and dazzling snow. When lighting up, protect eyes from direct ultraviolet rays.

Fasten seat belts in the car. Wear goggles or a visor when working with a lawn mower, trimmer. In case of solar eclipse, use special sunglasses.

To prevent child injuries, remove chemical, cleaning and detergent substances from children to inaccessible places. Use toys without sharp or small parts and corners. Teach your child how to handle scissors, pencils and other sharp objects.

Keep children away from working electrical tools and devices. Do not allow to watch the sun without glasses. Do not let children be where fireworks and fireworks are being let out.

The eyes are an important organ and require a careful and careful attitude towards themselves. It is necessary to protect your eyesight, avoid injury to the eyes. After all, even a slight contact with the smallest particle can lead to irreversible consequences.

EMERGENCY HELP FOR THEM.

Damage to the organ of vision and its auxiliary apparatus make up about 10% of all eye diseases and require urgent diagnosis and urgent medical care.

Nurses are obliged to correctly diagnose injuries and provide emergency first aid for them, since the outcome of eye injuries depends on the timeliness and correctness of first aid.
Eye injuries can occur at work, in everyday life and are most often associated with violation of safety rules, careless handling of sharp objects, explosives, prank and dangerous games of children.
Any trauma to the eye must be carefully recorded in medical records, as it can be subject to review by the administrative or judicial apparatus.

A paramedical worker who examines a patient with an injury for the first time should carefully collect an anamnesis (where, under what circumstances the injury occurred), write down complaints, immediately check (at least roughly) vision, carefully examine the patient, provide him with emergency first aid and send him, if necessary. to a specialized institution.

Injuries to the organ of vision are very diverse.

They may be:

mechanical (blunt injuries, non-penetrating and penetrating injuries),
chemical burns,
thermal burns,
defeat of radiant energy.

In terms of severity, injuries are divided into:

lungs,
medium,
heavy.

Allocate:

orbital trauma
auxiliary apparatus of the eye and eyeball.

MECHANICAL DAMAGE.

Orbital trauma.

Often combined with facial injuries, the eye and its auxiliary apparatus are often affected. With injuries of the orbit, hemorrhages in the eyelids often occur; if blood is poured out of the eye, it protrudes - exophthalmos.

With trauma to the orbit, her bones are often fractured, especially in children; to identify them, an x-ray of the bones of the orbit must be taken. The damaged bones of the orbit can be displaced, and then the eyeball changes its position - it either sinks (enophthalmos) or bulges (exophthalmos).

Injuries to the orbit can be accompanied by damage to the optic nerve up to its rupture. In this case, the victim immediately loses his sight. If, at the same time as the trauma of the orbit, the trauma of the paranasal sinuses occurred, then air penetrates into the tissue around the eye and, when pressed on them, a crackle is felt (crepitus). In case of injury, the lateral muscles of the eye can be damaged, which leads to limitation of its mobility.

Injuries to the auxiliary apparatus of the eye.

With injuries, the eyelids and lacrimal passages are most often damaged.
Injuries to the eyelids are accompanied by hemorrhages. Injury of the eyelids can lead to tears and tears, injuries to the eyelids are very dangerous at the inner corner of the eye, where the lacrimal tubules are located, if damaged, the outflow of tears is disturbed and the tears develop. lacrimation and lacrimation.

Patients with eyelid wounds after first aid should be referred to a hospital for specialized surgical care.

Conjunctival damage.

As a rule, they are mild, but they can mask injuries to the sclera, so such patients, after being examined by paramedics and providing emergency care, should be sent for examination to an ophthalmologist.

Superficial damage to the conjunctiva is often associated with the ingress of small foreign bodies that are visible during examination. Often, foreign bodies linger under the upper eyelid, therefore, if you complain about the feeling of a foreign body, you need to turn the upper eyelid and carefully examine the groove (subchondral groove), which runs at a distance of 1-2 mm parallel to the edge of the eyelid. Foreign bodies must be removed immediately.

Corneal damage.

Injury to the eye can damage the cornea. Superficial damage to the cornea - erosion - is also often accompanied by a foreign body sensation in the eye, photophobia, lacrimation. The eye turns red (ciliary injection).

To detect corneal erosion, a 1% solution of fluorescein is instilled into the eye, which is washed off with a solution of furacilin 1: 5000. The eroded surface of the cornea turns greenish.

Corneal erosion must be treated, otherwise it will lead to corneal inflammation -

Treatment.

For 2-3 days, a 30% solution of sulfacyl sodium is prescribed 1 drop 4 times a day, an ointment with sulfa drugs or antibiotics is placed in the lower eyelid 2 times a day.
To improve the epithelialization of the cornea, you can use a 1% solution of quinine hydrochloride and vitamin drops with riboflavin (1: 1000).
If a foreign body (speck, thorn of a plant, etc.) is found in the cornea, it must be removed immediately, otherwise inflammation of the cornea will develop. Superficial foreign bodies can be removed by mid-level medical professionals, deep - by ophthalmologists. After removing foreign bodies from the cornea, the same treatment is prescribed as for corneal erosion.

Blunt trauma to the eye (contusion).

They can occur from a blow with a blunt object, while all parts of the eyeball can be damaged to one degree or another. Most often there are hemorrhages under the conjunctiva, in the anterior chamber, vitreous body, retina.

Possible tears of the pupillary edge of the iris or separation of its root (iridodialysis), as a result of which the pupil changes its shape. Often, the ciliary girdle is damaged and subluxation (partial dislocation) or dislocation of the lens occurs. If the capsule is damaged, the lens becomes cloudy, traumatic cataract develops.

In the fundus, there is a concussion of the retina, ruptures of the choroid and retina are possible. For a more accurate diagnosis of traumatic injuries, after the provision of first aid, a patient with blunt trauma should be examined by an ophthalmologist who will prescribe appropriate treatment for him.

Penetrating wounds of the eye.

These wounds are usually inflicted with sharp objects and lead to a violation of the integrity of the capsule of the eye (i.e., the cornea or sclera). Depending on the site of damage, the capsule produces corneal, limbal, scleral wounds. These injuries are dangerous both in themselves and because of possible complications.

Reliable signs of penetrating wounds are the presence of a through wound, loss of internal membranes in it, a foreign body inside the eye. Additional signs indicating that the wound is penetrating are a decrease in intraocular pressure (hypotension), outflow of aqueous humor, crushing: or deepening of the anterior chamber of the eye.
In case of penetrating wounds, immediately after providing emergency care, the patient is urgently taken to an ophthalmological hospital for wound treatment.

Complications of penetrating eye injuries.
Such complications are often associated with the ingress of foreign bodies into the eye, most often metallic magnetic or non-magnetic fragments.

Diagnostics.
To identify them, special radiological surveys:

X-ray localization method according to Comberg - Baltin or
skeletal radiography according to Vogt.

X-ray localization according to Comberg - Baltin It is performed using an aluminum indicator prosthesis with a hole for the cornea in the center, on the side of which there are 4 lead marks. After anesthesia with a 1% solution of dicaine, a prosthesis-indicator is applied to the eye so that the marks are located at 12, 3, 6, 9 o'clock. Direct and lateral images are taken, on which the exact location of a foreign body is determined using measuring circuits.

Skeletal Vogt X-ray allows you to identify small foreign bodies in the anterior part of the eye.

First aid and treatment for penetrating eye wounds.

Magnetic foreign bodies removed from the eye using an electromagnet or permanent magnet, anterior or diascleral way.

If metallic foreign bodies remain in the eye, then serious complications arise: if they contain iron - siderosis, copper particles - chalcosis.
With siderosis, the iris acquires a rusty color, rusty spots appear under the lens capsule, the retina and optic nerve are affected, inflammation of the choroid is possible -
With chalcosis in the tissues and environments of the eye (iris, vitreous humor, retina), yellowish-green oxides of copper are deposited in the form of a sunflower, especially noticeable in the lens (copper).
Siderosis and chalcosis can develop at different times after the injury and lead to the death of the eye.

If for some reason it is not possible to remove metallic foreign bodies from the eye, then drugs are used for the purpose of resorption, and to remove copper, they are prescribed electrophoresis with unitiol.

Penetrating wounds are most often infected and often complicated by inflammation of the choroid. , purulent infection of the inner membranes or all parts of the eye
A ciliary or mixed injection appears, the moisture of the anterior chamber becomes cloudy, pus may appear in it, the color of the iris and the shape of the pupil change. The conjunctiva becomes edematous, the fundus reflex becomes greenish. All this is accompanied by pain in the eye area, headache, and often an increase in body temperature.

If intensive treatment antibiotics broad spectrum of action, antistaphylococcal gamma globulin intramuscularly or retrobulbar, paracentesis with washing of the anterior chamber does not relieve inflammation, then the eye must be removed (enucleation).

The same is shown for subacute fibrinoplastic damaged eye, when, despite treatment, the ciliary injection continues, cell deposits (precipitates) appear on the posterior surface of the cornea, adhesions of the iris to the cornea or lens occur, and intraocular pressure decreases.
Such an eye poses a danger to the second, intact, eye, since it can develop sympathetic (sympathetic ophthalmia)- malignant inflammation of the choroid of the intact eye, resulting from subacute fibrinoplastic inflammation of the eye with a penetrating wound.

Forecast for sympathetic inflammation very unfavorable. The most reliable prevention of it is enucleation of the eye with a penetrating wound, if vigorous anti-inflammatory therapy is ineffective and fibroplastic continues in it.
In previous years, sympathetic inflammation always led to the death of the eye, now the prognosis has improved.

The effect is achieved by applying:

corticosteroids internally and locally,
immunosuppressants,
antibiotics,
desensitizing and other means.

BURNS EYES.

Eye burns are:

thermal,
chemical,
as a result lesions with radiant energy.

Thermal burns caused by high temperatures (flames, boiling liquids, hot metal) .
Chemical- acids and alkalis. Acid burns cause coagulation - dry scab - tissue (coagulation necrosis), alkalis - colliquation necrosis(tissue liquefaction), so the most severe burns are caused by alkalis.

Light burns are expressed in redness, swelling of the eyelids, hyperemia and edema of the conjunctiva, erosion of the cornea.
Severe burns are manifested by necrosis, tissue rejection. Often, in this case, adhesions of the eyeball with the eyelids (simblefaron) are formed. Necrotic areas of the cornea are replaced by opaque connective tissue. A persistent opacity in the form of a spot or a leucorrhoea remains on the cornea.

Particularly noteworthy are changes in the organ of vision caused by exposure to various types radiant energy and (infrared, ultraviolet, X-rays, radio and microwaves, etc.), which are often associated with a violation of safety at work (occupational injury).
For example, during electric welding, ultraviolet irradiation can cause electrophthalmia if eye protection is not observed. 4-10 hours after exposure to radiation, photophobia, lacrimation, redness of the eyes appear, on the cornea - small blister-like swelling, erosion.
The outcome of burns is largely determined by the timeliness and correctness of the provision of emergency care.

EMERGENCY HELP FOR VISUAL INJURIES AND

ITS AUXILIARY EQUIPMENT.

In case of damage to the orbit and the auxiliary apparatus of the eye, it is necessary to enter the patient anti-tetanus serum and put on the wound sterile dressing.
For large, contaminated wounds, a single dose should be administered as a preventive measure. antibiotic a broad spectrum of action.
The injured person is sent by an ambulance car (in its absence - by a car) to the ambulance station or to the nearest hospital. If there are signs of simultaneous brain damage (nausea, vomiting, loss of consciousness, bleeding from the nose, mouth, ears), the patient is delivered on a stretcher.
If foreign bodies enter the conjunctival sac emergency first aid is to remove them. First, the lower eyelid is examined, it is turned inside out, pulled downwards. The foreign body is removed with a bandage or cotton wool, wound on a match and moistened with boiled water. The upper eyelid is examined after its eversion. The foreign body is most often retained in the subchondral groove at the edge of the eyelid. You need to remove it without anesthesia in order to navigate the patient's feelings.
If there is no foreign body behind the eyelids, you need to see if it is in the cornea.
Corneal foreign body removed after anesthesia by instillation of 0.5% dicaine solution, 3% cocaine solution or 5% novocaine solution.
The patient must be warned that during the removal of a foreign body, in no case should you turn your eyes or move your head. First, try to remove the foreign body from the cornea with a sterile cotton swab dipped in boiled water. If this fails, then the patient should be directed to an ophthalmologist, where the foreign body is removed with a spear-shaped knife, a fluted chisel or the tip of an injection needle. If necessary, this procedure can be performed by a paramedic under the supervision of a physician.
The cornea should be well lit: it is convenient to use a supra-forehead loupe to enlarge it. With the thumb and forefinger of the left hand, you need to push the patient's eyelids apart, and take the instrument with three fingers of the right hand. They try to pry it with the end of the tool taken to extract a foreign body. If the foreign body is located deep in the layers of the cornea, then an optometrist should remove it.
After removing a foreign body from the conjunctiva, a 30% solution of sulfacyl sodium should be dripped into the eye. If a foreign body is removed from the cornea, after instillation, disinfectant eye ointment (1% tetracycline, 1% chloramphenicol, etc.) should be placed behind the eyelids.
The patient is prescribed a sick leave and an examination is prescribed in 1-2 days.

For blunt eye injuries the average medical professional cannot always determine the severity of injuries when examining a patient, but one should always think about the possibility of serious injuries.

The patient is given vaso-strengthening and blood coagulability drugs and is delivered by an ambulance to the eye department of the hospital for examination by an ophthalmologist.

For penetrating eye injuries or suspicion of such an injury, emergency first aid consists of:

in the introduction of anti-tetanus serum,
instillation of a 30% solution of sulfacyl sodium into the wounded eye.
intramuscularly inject a single dose of a broad-spectrum antibiotic, 1 ml of vicasol or etamsylate, inside - 1 g of sulfanilamide preparation and 0.05 g of ascorutin;
a sterile binocular bandage is applied and the patient is taken to the hospital on ambulance transport, where he can be provided with specialized ophthalmic surgical care;
If a foreign body is suspected, the patient should be guided in a position lying on the side on the side of the injured eye (if there is a foreign body inside the eye, this position will ensure its lowering to the sclera, from where it is easier to remove it).

For non-penetrating eye injuries emergency first aid consists of:

in the instillation of a 30% sodium sulfacyl solution and placing 1% chloramphenicol or other disinfectant ointment behind the eyelids. If the average medical professional doubts the nature of the injury, then assistance should be provided in full, as in the case of a penetrating eye injury. And in fact, and in another case, the patient is subject to further examination by a doctor.

With thermal burns of the eyes follows:

drip 30% sodium sulfacyl solution,
put a disinfecting eye ointment behind the eyelids,
apply a sterile bandage and deliver the patient to the eye trauma center.

With chemical burns of the eyes necessary:

remove the burn substance with a bandage or cotton swab and for a long time, for 10-20 minutes, rinse the conjunctival sac with plenty of water. If you know what caused the burn, then use an antidote as a washing liquid - for example, for burns with alkali - a 3% solution of boric acid, for burns with acids - a 2% solution of sodium bicarbonate. It is better to use a sterile enema balloon for rinsing. The flushing liquid is collected into the balloon, the eyelids are spread with the fingers of the left hand and a weak stream of solution is directed into the palpebral fissure. The patient tilts his head forward and holds the basin with his chin. In the absence of a balloon, you can rinse under running water using a moistened absorbent cotton wool, which must be carried along the palpebral fissure in the direction from the temple to the nose.
After abundant rinsing, a disinfectant solution of 30% sulfacyl sodium is instilled into the eye, 1% tetracycline ointment is applied.
For deep burns, it is necessary to inject tetanus serum. The patient is delivered to the eye trauma center.

For burns with radiant energy :

the patient should be placed in a darkened room,
protect your eyes from light,
cold lotions are applied to the eyes,
instill anesthetics (0.25% dicaine solution, 2% novocaine solution),
oil solutions (fish oil, vit min A),
disinfectant solutions (30% sodium sulfacyl).

CARE FOR PATIENTS WITH EYE DAMAGE.

Patients with eye injuries require special observation, as they may experience dizziness, vomiting, fainting, etc. Even in the absence of indications for hospitalization, patients with eye injuries should be observed for at least 2-4 hours and only then sent home with accompanying persons.

When a diagnosis of a penetrating wound is established, the patient's eyes are sent for surgical treatment of the wound. In the preoperative period, the patient is prepared for surgery. The movement of the patient's head should be minimal to avoid additional injury to the eye.

A cleansing enema is done for such patients only as directed by a doctor. Sanitization is carried out in the supine position, the patient is delivered to the preoperative ward on a gurney.

After the treatment of a penetrating wound during the return transportation of the patient to the ward, it is required to observe the complete immobility of his head.
In the postoperative period, the patient is on strict bed rest. The nurse must ensure the immobility of the patient's head, rest and care for him, monitor the course of the postoperative period, in which patients may experience complications: vomiting, psychosis, bleeding. Patient care in the postoperative period is described above.

Care of patients with severe burns similar to caring for patients with eye injuries.

The care of children with eye injuries should be especially careful. In babies, in the pre- and postoperative period, hands should be fixed to the crib, ensure constant monitoring of them and strict adherence to the doctor's prescriptions.

The largest number of visits to an ophthalmologist is caused by superficial eye injuries due to external factors: mechanical, chemical, thermal, electromagnetic radiation, etc.

Eye injuries result from sudden superficial damage to the cornea, conjunctiva, and eyelids, whose function is to protect the eyeball. They can occur anywhere and at any time - at work, at home, in the gym. Most often, they are caused by carelessness in the workplace, haste and non-observance of safety precautions... Such injuries can be the cause of lifelong disability, but usually with timely hospitalization, it is possible to fully restore vision.

In case of damage to the cornea, treatment is often conservative, any unskilled intervention is excluded. If the injury is severe, surgery is required.

The causes of damage are varied:

hitting the eye with metal shavings, dross when welding metal, glass shards;
blows with blunt or sharp objects;
burns by flames or chemicals.

All of them are hazardous to eyesight and require immediate medical attention. Household and not requiring medical attention can be considered getting into the eye of midges, specks, eyelashes.

The severity of the injury is inversely proportional to the pain experienced by the patient. Even a grain of sand can cause a severe attack of pain, while a penetrating wound does not cause such a symptom, but it is more dangerous.

Classification

According to their origin, eye injuries are divided into:

mechanical.
thermal.
chemical.
ultraviolet radiation.

Mechanical injuries include eye injuries sustained by a fall, blunt or sharp objects (tree branches, fingers) when struck, ingress of foreign bodies: glass, metal, sand, chips, etc. They are open and closed. Closed injuries include bruising and the most common erosion.

Open injuries include:

cracks or scratches in the cornea (after blunt trauma);
penetrating wound (entrance and exit are in the same place) - damage to the eyeball with a sharp object;
perforating wounds of the eyeball (entry and exit wounds are in different places);
intraocular foreign bodies.

Thermal burns include burns of the outer shells of the eye by fire, red-hot objects, and chemical burns as a result of exposure to the eye with chemicals (acids, alkalis, alcohol, etc.).

At the place of localization of the traumatic agent, the following options for the development of trauma are considered:

Corneal damage or erosion can lead to clouding and detachment.
damage to the mucous membrane of the eye or conjunctiva is accompanied by subconjunctival hemorrhage (there is a red white of the eye after a blow). Conjunctival ruptures are dangerous because they can hide the rupture of the inner membranes and require suturing.
damage to the eyelid includes wounds with hemorrhage. In the area of injury, hematomas with discoloration of the skin are possible. First of all, you should treat the wound and apply cold.
damage to the orbit and appendages - dangerous with such consequences as displacement of the orbital bones, impaired mobility of the eye, loss of membranes, etc.

Symptoms

Often, patients experience the following symptoms:

sharp pain;
constant lacrimation;
inability to look at the light;
decrease in the quality of vision;
swelling of the eyelids;
hemorrhage in the eye cavity.

Diagnostics

After interviewing the patient, the doctor should examine the sore eye and, if necessary, prescribe additional examination methods. To exclude a penetrating wound and find out the depth of the corneal lesion, doctors bury an eye fluorescein solution... Indicators of visual acuity and intracranial pressure are important. Next, the doctor should examine the inner surface of the upper and lower eyelids for the presence of the remnants of damaging bodies and then remove them.

For severe injuries, they resort to x-rays of the eye, magnetic resonance imaging and computed tomography. To identify complications, retinal angiography is prescribed.

Treatment

Eye injuries are common. Such injuries are often very dangerous and pose a threat of blindness, so only a specialist should be treated. In case of an injury to the eyelid or if the patient has rubbed the eye, first of all, the wound should be treated and cold applied.

If you just get a speck, you can independently provide first aid and clean your eye. This requires:

press the upper eyelid to the base.
holding the eyelid in this way and keeping the eye open, gently rinse it towards the inner corner.
if the foreign body is under the lower eyelid, carefully remove it with a sterile tissue or clean tissue.

After that, be sure to go to the hospital, as even a small grain of sand can cause severe irritation.

Treatment of corneal injuries, especially if a foreign body is stuck in it, cannot be carried out on your own and try to pull out the object. An urgent need to see a doctor.

After jet washing, the doctor removes foreign bodies from the eye using a microscope and special instruments.

You can not resort to the help of unskilled people and carry out eye cleaning, thus putting your health at risk. If the corneal wound is shallow (small scratch), absolutely waterproof and does not violate the curvature of the cornea, it must be sutured. If the wound is deep and is accompanied by prolapse of the iris, reconstruction is necessary. A badly stitched cornea will negatively affect the quality of vision. The consequences of corneal injuries depend on the depth of the injury and can lead to complete loss of vision.

Since objects could be infected and contain bacteria, eye drops are often prescribed for eye injuries with an antibiotic in order to protect the organ from the development of infection in it and prevent infection of a healthy one. Healing eye ointment is also used. To remove pain, anesthetic drops are used.

With erosion of the cornea, that is, shallow light lesions, the cure occurs already after 48 hours... The healing process takes a little longer in people with diabetes or dry eye syndrome. There is no need to cover the eye with a bandage, but it is worth seeing a doctor until the wound is completely healed.

In case of damage to the conjunctiva, they resort to surgery if the fit of the edges is not optimal. But usually this method is not used, but the wound is allowed to heal on its own, using only protective contact lenses and other drugs.

Chemical burns are usually caused by alkalis or acids. In such cases, immediate help is needed, since irreversible consequences occur very quickly. First aid is as follows: open your eye as wide as possible and rinse with running water about twenty minutes away from the nose so that the removed chemical does not affect the healthy eye. Next, you need to urgently see a doctor.

Light burns occur in cases of direct penetration of a stream of ultraviolet rays or during a long walk in the snow on a bright sunny day. You should cover your eyes with a damp, sterile cold dressing, while avoiding rubbing the organ.

In severe injuries, complete cure is usually not possible. The final visual acuity depends on the severity of the disease and the effectiveness of treatment. At the end of the course of therapy, it is necessary for some time to be observed by an ophthalmologist in order to diagnose in a timely manner the deterioration of the course of the pathological process.

Prevention

Prevention is fundamental. It consists of the following recommendations:

prevention of injury by observing safety measures. The use of safety glasses has reduced the number of accidents at work hundreds of times;
the use of helmets and masks to protect the face during sports - also significantly reduces the likelihood of eye injuries;
use caution when viewing and shooting fireworks, opening high pressure bottles, and in all situations with a high risk of eye damage.

It is important to understand that preventing a situation in which this kind of damage can occur is much easier than eliminating the consequences later. Therefore, for any actions of increased risk, you need to protect yourself as much as possible with the help of special protective equipment.

The human face is exposed to various traumatic factors. The most sensitive organ on the face is the eyes. Injury to the eye carries the risk of deterioration or loss of vision.

Therefore, when you are in the area of increased injury risk, it is necessary to protect the organ of vision. If damage does occur, see a doctor immediately.

Eye damage can be caused by any environmental factor:

mechanical - blow with a sharp or blunt object;
thermal - exposure to high or low temperatures;
electric - the effect of current;
chemical - the ingress of acids, alkalis, and other compounds.

The symptoms of an eye injury depend primarily on the causative factor. The strength and duration of exposure is important in predicting outcome. According to the severity of the course, light, moderate, severe injuries are distinguished.

Mechanical

These are the most common home and work injuries. They occur when you hit the eye with a blunt or sharp object.

Types of mechanical damage.

Minor injuries arising from the ingress of metal () or wood chips. It gets stuck in the mucous membrane or cornea, causing severe pain and tearing.
By contusion of the eyeballs, it is meant an injury resulting from a blow with a blunt object applied at a low intensity. The organ remains intact, the visual impairment is transient. With blunt eye trauma, there is a hematoma of the periocular region, in the conjunctiva.
Crush injury is an injury that leads to the destruction of the eyeball. Most often requires removal of the organ.
Contusion - occurs as a result of an indirect blow to the back of the head, temporal region. Outwardly, the organ remains intact, but the intraocular structures are displaced or destroyed. Most often leads to loss of vision.
When exposed to a sharp object (knife, needle, knitting needle), penetrating damage is observed. There is a narrow, but deep tissue destruction. Accompanied by acute pain. Complete restoration of vision is impossible.
Mechanical injuries are also referred to. It can enter the conjunctiva, cornea, and internal structures of the eye.

The most dangerous are mechanical eye injuries in a small child. They are accompanied by damage to the bone receptacle of the organ and almost always cause irreversible damage.

Thermal

They are less common, can be both eye injuries at work, and household. Burns are more common than frostbite.

In everyday life, hot steam usually gets into the face. It causes damage to the mucous membrane, skin of the eyelids. In production, where temperatures exceed 100 * C, it is possible to involve the cornea in the pathological process.

Injury can be caused by scalding with boiling liquid, molten metal, liquid nitrogen. The eyeball is destroyed completely.

Chemical

More typical for industries with non-compliance with safety regulations. caused by various aggressive substances - acids or alkalis.

Under their influence, protein denaturation occurs, leading to melting of the eyeball, eyelid skin. The severity of the injury depends on the concentration of the substance, its amount and the duration of exposure.

Electrical

They are less common than other species, they are not isolated. If the current comes into direct contact with the eyeball, carbonization occurs. If the current is applied to another area, damage to the retina is observed.

You can see more details about household injuries and eye burns in the next program, says the ophthalmologist surgeon.

Damage treatment

For any eye injury, even minor, home treatment is impossible. A person cannot independently assess the degree of damage to the organ of vision, especially since some symptoms develop gradually.

Only an ophthalmologist will correctly diagnose, determine the severity of the injury and explain what to do, whether hospitalization is necessary. For a full examination of the organ of vision, the doctor uses Goldman lenses. This device allows you to examine all the internal structures of the organ from any angle.

First aid

If an eye injury occurs, the person is given first aid and taken to the hospital. First aid measures for eye injuries are determined by the cause. First of all, you need to stop the impact of the damaging factor.

Mechanical. Apply a clean eye patch, in case of penetrating trauma, stop bleeding.
Thermal. If exposed to high temperatures, apply a bandage, then apply cold. If the temperatures are low, only a bandage.
Chemical. Rinse eye with plenty of water.
Electrical. Emergency hospitalization.

Each person should know what to do if the eye is damaged in different situations. Competently provided first aid helps reduce the risk of complications and improve the prognosis.

What not to do

The eye is a very sensitive organ. Therefore, in case of damage to the eyeballs, it is forbidden to independently remove foreign bodies, try to neutralize the ingested chemical.

You can not use any folk remedies, medicines without a doctor's prescription.

Primary treatment

After the diagnosis is made, the doctor provides emergency care if needed. Then the issue of outpatient or inpatient treatment is decided. Mild injuries can be treated at home.

In most cases, eye injury requires surgical intervention:

removal of non-viable tissue;
stopping bleeding;
suturing of wounds.

Crush injury, massive penetrating injury, fourth degree burn - an indication for removing the eye.

Medication is prescribed to prevent bacterial complications if vision becomes cloudy after injury. The following drugs are used:

drops and ointments with antibacterial action - "Normax", "Uniflox", "Ophtocypro";
remedies for healing injuries - "Solcoseryl", "Korneregel";
preparations for restoring the outflow of tears - Vidisik, Systain Balance;
preparations for strengthening the lens - "Kartalin", "Oftan-katakhrom".

The duration of medication intake is determined by the doctor individually.

Prevention

Every person has a protective reflex to protect their eyes from damage. It consists in involuntary blinking, increased tear separation.

But this is an inadequate protection, therefore, to prevent injury, the following rules must be observed:

the use of glasses to protect the eyes from mechanical damage while working in traumatic conditions;
compliance with safety regulations when working with high and low temperatures;
adequate protection during work with electric current;
protection when working with chemicals.

Also, each person needs to know where to go if an injury occurs. In production, this is a medical office, in a domestic environment - an ambulance or a general medical institution.

Eye trauma is a dangerous condition that threatens with visual impairment up to its loss. Injury to this organ is an indication for immediate referral to a medical institution.

The human eye is a very sensitive and vulnerable organ, which, due to its physiological structure, is subject to external mechanical influences. Any injury to the eye is dangerous: some significantly impair a person's vision, while others can lead to lifelong disability.

Statistics show that men are more likely to receive severe eye injuries ( 90% of cases). Manufacturing work is also dangerous, while safety glasses can reduce the risk of injury by up to 10%.

Blunt trauma to the ocular apparatus

If the eye is damaged by a blunt object, then the condition is accompanied by hematomas (retrobulbar or lesions of the eyelids) and profuse hemorrhage. With contusion of the iris, there is damage to the pupil and its unnatural expansion up to 1 cm... At the same time, sensitivity to light is absent or poorly expressed.

The patient notes a sharp drop in visual acuity. A concomitant symptom is a violation of physiological accommodation (the ability of the organ of vision to adapt to darkness or bright light). If the blow was strong enough, then there is a risk of accumulation of blood mass in the front of the eye (hyphema), detachment of the iris layer.

If, during work, a person did not have eye protection from mechanical damage, then degenerative changes can affect the lens of the eye. Clouding of this part develops. If the lens capsule remains intact, then another pathology occurs - subcapsular cataract.

As a result of injury to the structure of the ligaments holding the lens, subluxation may develop, which will inevitably cause lens astigmatism and impairment of accommodative functions. In some cases, a changed lens prevents the normal outflow of fluid from the anterior cavity of the eye. On this basis, phakotopic (secondary) glaucoma develops.

In medical practice, there are frequent cases in which contusions of the organs of vision cause rupture of the sclera of the eye. This condition is also characterized by edema of the eyelids, hypotonia of the eyeball, exophthalmos, conjunctivitis.

Damage to the eyeball

Non-penetrating wounds do not perforate the important membranes of the eye. But such mechanical injuries damage the outer epithelium of the eyeball and create a favorable environment for secondary infections - traumatic keratitis, corneal erosion. The pathological condition is characterized by profuse lacrimation, fear of bright light.

The symptoms of penetrating mechanical damage are:

an open wound through which the prolapse of the vitreous humor or iris is visible;
hole in the iris;
the presence of a foreign particle or object inside the eyeball;
hypotension;
loss of lens transparency;
hemophthalmus;
change in the natural shape and size of the pupil;
decreased visual abilities.

Penetrating injuries are dangerous not only for their symptoms, but also for complications that often develop in patients.

The consequence can be uveitis, iridocyclitis, endophthalmitis, complications of intracranial localization.

Orbital injury

Damage of this nature is usually accompanied by a violation of the integrity of the tendon of the oblique muscle of the eye, which provokes diplopia and strabismus. A strong blow to the orbital area can cause a fracture of its walls and displacement of sharp debris, which will lead to a decrease or increase in the orbital cavity. Patients with such injuries experience unnatural bulging (exophthalmos) or retraction of the eyeball (endophthalmos).

Protecting the eyes from environmental factors is extremely important, as, for example, orbital injuries very often result in sudden blindness that does not respond to treatment. This occurs as a result of severe hemorrhages into the cavity of the eyeball, ruptures of nerve messages and structural membranes of the eye, crushing of the eyeball.

Diagnostics

To establish the severity of mechanical damage to the eye apparatus, you should contact a narrow specialist - ophthalmologist... He will begin the diagnosis of the problem by collecting complaints and studying the clinical picture. Further, the patient will be assigned to all types of examinations of the organs of vision.

In case of mechanical damage to the eyeball, it is necessary to carry out an X-ray of the eye orbit of an overview type, which is usually performed in two projections. This analysis will confirm or exclude bone damage and the introduction of foreign objects.

Among the mandatory research methods, there is an examination of the structure of the eye by means of biomicroscopy, diaphanoscopy, ophthalmoscopy. It is also necessary to measure the patient's intraocular pressure. If the injury is accompanied by a protrusion of the eye, then the degree of damage will be revealed by exophthalmometry. For various visual impairments after mechanical damage, it is recommended to investigate the degree of accommodation, refraction and convergence of the injured eye. The consequences of damage to the stratum corneum can be studied using a fluorescein instillation test.

To study post-traumatic retinal tissue modification, the method of fluorescence angiography is used.

The study of structural changes in the retina (localization and degree of detachment) is carried out by means of ultrasound of the orbits of the eye. Ultrasound biometric tests will help identify and assess the consequences of contusion.

After specialized instrumental diagnostics, the patient will be referred for a consultation neurosurgeon, neurologist and ENT doctor... As additional studies, computed tomography and X-ray analysis of the head are prescribed.

First aid for eye injuries

In case of eye injuries of a different nature, the victim should immediately be provided with high-quality and correct first-aid assistance. It is as follows:

If the injury received by a person has a cut character, then you should cover the eyeball and eyelid with a sterile (or clean) tissue as soon as possible, securing it with a bandage. It is recommended that the same manipulations be done with the intact eye in order to exclude the possibility of their synchronous movement. The injured organ of vision should be immediately shown to a narrow specialist.
A blow to the eyeball is also an emergency. You can use the same cloth bandage, but after soaking it in cold water. If there is no water nearby, a chilled object should be applied to the bandage.
If during work a person did not use glasses to protect the eyes, and any foreign body got on the mucous membranes or the eyeball, then there is no need to try to remove it yourself (especially if there is a possibility of its introduction into the body of the eyeball). All you can do before a medical examination is to cover your eyes with a handkerchief. If the foreign object is visually distinguishable, and moves freely along the mucous membrane, then it is better to remove it with a homemade swab from a clean tissue. The foreign body under the upper eyelid can only be removed with the help of an "assistant". If the actions did not work, then you need to see a doctor.
Damage to the eyeball of a penetrating nature is the most dangerous. Therefore, stopping bleeding or reducing blood loss is considered the most important task. If the victim has a knife or other penetrating object in his eye, it is strictly forbidden to remove it before the arrival of medical assistance. It is only allowed to press the fabric against the injured eye, and cover the second with a hand or a scarf. Such manipulations may not stop bleeding, but will definitely reduce blood loss.

Treatment

As practice shows, each individual case of injury to the organ of vision requires an individual approach and treatment. If injuries during trauma affected only the eyelids (cut of the epidermis), then medical treatment of the wounds, their partial excision (if necessary) and the imposition of surgical sutures are performed.

Elimination of superficial damage to the organs of vision (eye cut) is performed through conservative therapy. Preparations for treatment - ointments for laying behind the eyelids, antibacterial drops and antiseptics. If a foreign body has managed to penetrate into the mucous eyes, then it is necessary to carry out a procedure for jet washing of the conjunctival cavity, followed by extraction of the fragment.

Treatment of a bruised eyeball involves providing complete rest to the victim. During the period of treatment, instillation of Atropine and Pilocarpine is carried out, the indicator of eye pressure is monitored.

The affected eye is covered with a sterile binocular bandage. To resolve the ocular hematoma, the patient is prescribed antibiotic therapy and subconjunctival administration of the drug Dionin.

In some cases, surgery is the only treatment. Doctors suture the sclera, perform vitrectomy, remove the deformed lens and implant an artificial lens, laser coagulation.

Prevention

In order to prevent possible injury to the eye apparatus ophthalmologists it is recommended to use glasses at work and at home during hazardous work to protect the eyes from mechanical damage.