Penetrating and perforating injuries
Both are serious emergencies and need to be addressed rapidly
It can be due to trauma by sharp and pointed instrument or trauma by foreign bodies travelling at high speeds
It may cause damage by the following mechanisms
- 1. Introduction of infection – purulent microbes enter causing abscesses in the cornea , purulent iridocyclitis, endophthalmitis or Panophthalmitis
- 2.Iridocyclitis (post traumatic) → very frequent and needs to be dealt with rapidly
- 3. Mechanical effects (mechanical penetration/perforation of structures)
- - conjunctiva wounds present with subconjunctival haemorrhage and if more than 3mm are sutured.
- - Cornea wounds : can be uncomplicated where there is no prolapse if intraocular contents so only swelling next to margin occurs but not stitching needed but bandage + atropine + antibiotic. Above 2mm= suturing needed Complicated wound involve prolapse usually of iris, lens even vitreous . Careful suturing needs to be done having cut of the prolapsed iris to prevent infection, lensectomy as well as viterectomy may be needed
- -Sclera injuries are treated as the above
- -Lens if lens and vitreous prolapse , they should be removes too and small wounds in the anterior side lead to cataract (stationary, late rosette / complete)
If eye is severely damages, it is usually removed.