Trauma Ocular
Trauma comes from the Greek word for injury and trauma is a general term that covers all internal or external injuries caused by violence outside.
Ocular trauma has peculiarities that differentiate it from the trauma of the other body parts, because of the extreme sensitivity of the eyeball. As in other organs, the healing of trauma is the completely normal functioning in the left eye traumatic injuries almost always represents a sequel to a functional deficit. If the body is injured the cornea, the transparent and scar alters the shape of the surface if the lens, cataract occurs and if the injured retina, vision is definitely more or less compromised.
According to Jose Ignacio Cortes, ophthalmic medical section of the Fundación Santa Fe de Bogota, ocular trauma is classified into two categories: blunt injuries and penetrating injuries. The 48.2 percent of eye injuries are both forceful and 48 percent of injuries are pervasive. The male is the most affected with 87 per cent of children under 10 years account for 4 percent of patients. 50 percent of injuries are occurring at work, 25 percent in children’s games and a 5 per cent in sports.
Classification
No penetrating wounds of the eyeball
Abrasion or erosion:
Corneal foreign bodies in conjunctiva, covers approximately 8.4% of ocular trauma consultation. Symptoms: If the lesion is located in the cornea, is expressed in the following symptoms, pain, foreign body sensation that increases with the flicker, tearing, decreased visual acuity in the cornea and blepharospasm.
Contusions:
The bruises are capable of producing.
1. Bleeding and swelling of the eyelids
2. Subconjunctival hemorrhages
3. Edema or rupture of the cornea
4. Hifema (blood in the inner chamber), is the decline in visual acuity.
5. Iridodiálisis (rupture of the root of the iris)
6. Traumatic paralysis of the pupil
7. Traumatic cataract
8. Retinal
9. Optic nerve avulsion
Orbital fractures:
Is another injury secondary to blunt trauma. Can manifest clinically by.
1. Facial asymmetry
2. Ecchymosis
3. Pain
4. Limitation of eye movements
5. Palpation of the fracture of the orbital rim
6. Diplopia in the look down
Burns
Heat:
For water vapor, liquid or contact with hot objects.
Chemical:
Produces extensive destruction with unwanted healing, excessive inflammatory response by liquefaction necrosis. Acid by coagulation necrosis or denaturation of proteins in the tissues. Treatment: profuse irrigation with neutral solution, after instillation of topical anesthesia, midriáticos use of waste and cleaning of the substance and fabric surface, so that the process of necrosis, mainly in alkali burns, in which case should be cleaned funds conjunctival sac with isopos cotton.
Penetrating wounds
Are handled as superficial erosions but may have the following events:
1. Laceration without herniation
2. Laceration with herniation
3. Intraocular foreign body
For any Perforating wound occlusion are shown not comprehensive, topical antibiotics – systemic and surgical repair if the wounds are more than two to three millimeters. Suitable materials should be used in the suture to prevent future complications. These are the reasons why the conduct subsequent to the diagnosis must be made by the ophthalmologist.
When suspected intraocular foreign bodies, the study should be complemented with the help of X-ray, CT, CT and ultrasound for localization of foreign body, for medical legal reasons. All intraocular foreign body should be treated on suspicion of exogenous endophthalmitis for the high frequency of contamination of foreign bodies.
Injuries eyelids:
The wounds that do not involve the eyelid margin can be as suturing the wounds of the skin, with the difference being a deque vascularised area, should not be subjected to resections should refer patients to eye with the following injuries:
1. Those include the possible canthus canalículos lacrimal section.
2. Lacerations deep commitment to lift the upper eyelid.
3. Commitment of the free edge of the eyelids.
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