Eye diseases. Eye contusions (most important)

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Eye diseases. Eye contusions (most important)

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38. Contusion of the eye

Blunt injuries of the first degree are characterized by reversible damage to the appendages and the anterior part of the eye, visual acuity and field of vision are completely restored.

With blunt injuries of the second degree, damage to the appendages, anterior and posterior parts of the eyeball is observed, mild residual effects are possible, visual acuity is restored to at least 0,5, the boundaries of the visual field can be narrowed by 10-20°.

With blunt injuries of the third degree, more pronounced residual effects are possible, a persistent drop in visual acuity within 0,40,05, narrowing of the visual field boundaries by more than 20 °.

Blunt injuries of the fourth degree are characterized by irreversible violations of the integrity of the membranes of the eye, hemophthalmos, damage to the optic nerve. Visual functions are almost completely lost.

Treatment. For intraocular hemorrhages, oral administration of rutin (vitamin P), ascorbic acid, and calcium chloride is indicated; in case of retinal concussion, dehydrating agents are prescribed (25% solution of magnesium sulfate intramuscularly, 40% solution of glucose intravenously, etc.), vitamin therapy (orally and parenterally, especially B vitamins). After a few days, oxygen injections under the conjunctiva of the eyeball, ionogalvanization with dionine or potassium iodide, and ultrasound are prescribed to resolve the hemorrhages.

With dislocation and subluxation of the lens, accompanied by constant eye irritation or hypertension, its prompt removal is indicated, with retinal detachment diathermo, cryo or photocoagulation with shortening (filling, depression, corrugation) of the sclera. With subconjunctival ruptures of the sclera, the wound is sutured, followed by conservative therapy with antibiotics and corticosteroids.

A metal magnetic foreign body is removed from the cornea with a magnet, they are removed using a spear-shaped needle, and disinfectants are prescribed (30% sulfacyl solution, 1% synthomycin emulsion).

Multiple small foreign bodies in the conjunctiva of the eyeball must be removed only if the eye is irritated. Large foreign bodies are removed with a lance-shaped needle in the same way as corneal foreign bodies, after instillation of a 1% dicaine solution.

Orbital injuries can be the result of blunt trauma and wounds. In some cases, they are accompanied by subcutaneous emphysema, which most often occurs when the lower inner wall is damaged and is characterized by crepitus, bone defects.

Fractures of the outer wall of the orbit may be accompanied by ruptures of the outer parts of the eyelids, hemosinus of the maxillary sinus, lockjaw. With fractures of the inner wall, various changes are observed in the lacrimal ducts, tears of the inner corner of the eyelids and severe damage to the eyeball. Injuries to the lower wall are complicated by hemosinus and fractures of the zygomatic bone.

Author: Shilnikov L.V.

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