Closed globe injury
A type of Contusion hence no corneal or scleral full thickness laceration and the affects can vary and affect each part differently.
Cornea
Simple abrasions may occur which are painful and can be best seen using fluorescein but they heal within 24hrs with pad after antibiotic .
Recurrent corneal lesions usually occur due to loosely attached epithelium usually fixed by removing by that lose epithelium
Might become blood stained if hyphaema is present or due to the increase in IOP, thus it becomes red and it clears very slowly ; even years
Deep corneal opacity may result from accompanying oedema
Sclera :May be partial thickness laceration (lamellar )
Anterior chamber
Hyphaema/exudate accumulation in the anterior chamber may be seen after injury to iris or ciliary vessels
Iris, pupil and ciliary body
Ciliary nerves may be irritated leading to miosis or mydriasis which is due to the impact itself and may be permanent rather than nerve irritation.
The pupillary margin may rupture ,radiating tears from the iris may be seen , iridodialysis (detachment of iris from its roots ; appearing of biconvex black shadow in periphery), antiflexion is when the detached part rotates so that the posterior surface in anteriorly and vice versa, retroflexion when the whole iris is detached hence it is not seen anymore, aniridia, occurs when the iris forms a clump in one area only. Inflammation may occur: iridocyclitis, iris atrophy (grey patches and pigments changes. Atropine+ antibiotics+ steroids
Lens
A vossius ring may be seen (circular ring of brown pigment) concussion cataract; which may be present as rosette cataract which is most typical or traumatic zonular cataract as well as diffuse (total ) concussion cataract. Following trauma, subluxation/dislocation can occur
Vitreous
Liquefaction and infiltration may occur which appears like clouds of fine opacities , detachment may occur, or even vitreous haemorrhage or even herniation which would dislocate the lens and affect ciliary body , iris as well as clarity of cornea
Choroid
It may rupture seen as whitish crescent , haemorrhage may occur and detachment or traumatic choroiditis (seen as patches of pigmentation)
Retina
Berlin’s oedema is very common appearing as milky white cloudiness with a cherry red sport in the foveal region
Haemorrhages may also follow, tears, detachment, macular oedema or tractional bands due to fibrotic changes
IOP
IOP Increases in closed globe trauma which then can elad to traumatic glaucoma as well as traumatic hypotony