Ocular trauma
The eyes are well protected by the lids , projected margins of the orbit , the nose and a cushion of fat from behind
In General you can divide ocular injuries as mechanical and non-mechanical
The non-mechanical include chemical, thermal, electrical and radiational injuries
Mechanical Injuries include: extraocular foreign bodies, blunt trauma, perforating injuries and sympathetic ophthalmitis
There is a new use of terminology when speaking about mechanical injuries it is classified around the use of the terminology eyewall= outer fibrous coat i.e. Cornea and sclera
Closed globe injuries means that the eyewall does not have an injury across its full thickness but there is intraocular damage.
This includes contusion which is defines as a blow with a blunt instrument, in which the subsurface tissue is injured but the skin is not broken hence the injury can be distant and not only at site of impact (e.g. bruises)
It also includes lamellar laceration when there is a partial thickness wound of the eyeball by a sharp object or due to blunt trauma.
Open globe
Full thickness involvement of sclera/ cornea or both , which includes
Rupture when the full thickness of the eyewall is affected caused by blunt trauma which occurs because the IOP increases so much that the outer fibrous coat cannot resist it.
Laceration is similar to rupture only that the full eyewall thickness is affected by a sharp object which can be penetrating which means there is a single laceration or perforation meaning that it the sharp object entered and exited at another site.
Extra ocular foreign bodies
They are very common especially among industrial and agricultural worker and the most common site are the conjunctiva be it fornixes, bulbar or palpebral conjunctiva as well as the cornea usually resting in the epithelium or superficial trauma but rarely in deep stroma
Foreign bodies include iron, emery ,coal, particles of dust/sand/steel, glass, wood, small insects as well as agricultural products like rice grains, husks even insect wings.
Symptoms usually include discomfort watering ,redness, pain , photophobia and defective vision if cornea is involved especially in the centre.
The best way to examine corneal wounds are via the use of Slit-lamp examination with fluorescein staining and the conjunctiva is mainly examined using oblique illumination and double eversion of the upper eyelid. Congestion is clear as well as blepharospasm.