Eye diseases. Frostbite and other eye injuries (most important)

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Eye diseases. Frostbite and other eye injuries (most important)

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40. Frostbite and other eye injuries

Frostbite of the eyeball is extremely rare, since the protective apparatus protects the eye from exposure to low temperatures. However, under unfavorable conditions (workers of Arctic expeditions, pilots, athletes, etc.), as a result of the absence of cold receptors in the cornea, cases of frostbite of the cornea are possible.

Subjective sensations during frostbite are manifested in the feeling of a foreign body under the eyelids. Since in such cases, medical workers do not detect foreign bodies, anesthesin (dicaine, lidocaine) is instilled as first aid. This, in turn, aggravates the conditions of frostbite, since the eye loses all sensitivity, and the protective reflex of closing the eyelids and moistening the cornea stops.

Objectively, during frostbite, tender subepithelial vesicles appear in the cornea, on the site of which erosions subsequently form: eye irritation is absent at first and occurs only 68 hours after frostbite (like ultraviolet burns). According to the severity of frostbite are divided in the same way as burns.

Treatment. Instillation of miotics, vitamin drops, application of 1% synthomycin emulsion or sulfacyl ointment.

Combat damage to the organ of vision

Combat injuries of the organ of vision have a number of significant features compared to peacetime injuries. Unlike household injuries, all combat injuries are gunshot wounds. More often, eye injuries are caused by shrapnel, bullet wounds are rare. Wounds, as a rule, are multiple and are combined with powder gas burns.

A characteristic feature of combat injuries is a high percentage of perforated wounds and severe contusions of the eye, damage to the orbit, combined wounds, combined with skull and brain injuries.

The main principle of treatment is the phasing with the evacuation of the patient as directed. First aid (the application of a bandage from an individual package) is provided to the wounded on the battlefield by a comrade or medical personnel. The first medical (eye) aid (dressing and drug treatment) is provided on the day of injury in the SME or on the PHC. On the same day, the wounded is sent to the PPG, GLR or evacuation hospital, where he is assisted by an ophthalmologist.

The first ophthalmic care unit is the Army Ophthalmic Reinforcement Group, part of the ORMU. These groups, together with groups in other specialties, are transferred to the KhPPG, where wounds are treated for the wounded. Slightly wounded soldiers finish treatment in these hospitals and return to the front. Seriously wounded soldiers are sent to the evacuation hospital of the first and second echelons of the GBF. They provide full-scale ophthalmosurgical care.

The wounded, who need long-term treatment, are evacuated from the GBF to the evacuation hospitals of the inner region.

Children often experience damage to the eye, similar to combat: when launching rockets, explosions of capsules, cartridges, which are produced without adult control.

Author: Shilnikov L.V.

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