III. Exam

  1. Visual Acuity (always)
    1. Consider Topical Eye Anesthetic first if light sensitive
    2. Delay only in cases of Chemical Eye Injury (irrigation precedes acuity exam)
  2. Visual fields by confrontation
    1. Defect suggests Retinal, Optic Nerve or CNS injury
  3. Pupil exam
    1. Evaluate for pupil size and reactivity
    2. Swinging Flashlight Test
    3. Tear drop shaped pupil suggests Globe Rupture
  4. Anterior chamber exam
    1. Fluorescein stain for Corneal Epithelial Disruption
    2. Evert upper Eyelid to observe for Eye Foreign Body
    3. Findings
      1. Foreign body
      2. Corneal Abrasion or Laceration
      3. Hyphema
  5. Extraocular Movement
    1. Upward gaze problem suggests orbital floor Fracture
  6. External eye findings
    1. Eyelid ecchymosis
    2. Proptosis
    3. Trismus suggests lateral orbital wall Fracture
    4. CN 5-2 Paresthesias suggests orbital floor Fracture
  7. Funduscopic Exam (Red Reflex)
    1. Altered Red Reflex suggests serious Eye Injury
  8. Specific tests
    1. Seidel Test (evaluation of Globe Rupture)

IV. Evaluation: Red Flags (require immediate ophthalmology evaluation)

  1. Sudden decrease in Visual Acuity
  2. Visual field defect
  3. Painful Extraocular Movements
  4. Photophobia
  5. Diplopia
  6. Proptosis
  7. Light Flashes or Floaters
  8. Pupil with irregular shape (e.g. tear drop)
  9. Hyphema
  10. Lights seen with halos
  11. Suspected Globe Rupture (e.g. broken eyeglasses)
  12. Medial canthus injury

V. Prevention

Images: Related links to external sites (from Google)

Ontology: Eye Injuries (C0015408)

Definition (MEDLINEPLUS)

The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or work in certain jobs, you may need protection.

The most common type of injury happens when something irritates the outer surface of your eye. Certain jobs such as industrial jobs or hobbies such as carpentry make this type of injury more likely. It's also more likely if you wear contact lenses.

Chemicals or heat can burn your eyes. With chemicals, the pain may cause you to close your eyes. This traps the irritant next to the eye and may cause more damage. You should wash out your eye right away while you wait for medical help.

Definition (MSH) Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries.
Definition (CSP) damage or trauma inflicted to the eye by external means including both surface injuries and intraocular injuries.
Concepts Injury or Poisoning (T037)
MSH D005131
ICD10 S05.9 , S00-S09
SnomedCT 367132005, 367423000, 21839005, 211485000, 157358003, 269350004, 125669007
English Eye Injuries, Injuries, Eye, Eye Injury, Injury, Eye, Injury of eye, NOS, Eye injury, Injury of eye, EYE INJ, INJ EYE, Ocular injury, eye injury, eye trauma, eye trauma (diagnosis), Eye injury NOS, Ocular injuries, INJURY, EYE, EYE INJURY, Injury of eye NOS, injuries of eye, Eye Injuries [Disease/Finding], ocular injury, Injury;eye, ocular injuries, eye injuries, eye; injury, injury; eye, ocular; wound, wound; ocular, Ocular Injury, Injury of eye (disorder)
Italian Lesioni traumatiche dell'occhio, Traumatismo dell'occhio, Traumatismo dell'occhio, NAS, Lesioni dell'occhio
Dutch oogletsel NAO, letsel; oog, oculair; wond, oog; letsel, wond; oculair, oogletsels, oogletsel, Letsel, oog-, Oogletsel, Oogletsels, Oogverwonding
French Traumatisme oculaire SAI, Lésions traumatiques de l'oeil, Lésions traumatiques des yeux, Blessures de l'oeil, Blessures des yeux, Traumatismes oculaires, Lésions oculaires, Lésions traumatiques oculaires, Blessures oculaires, Traumatisme oculaire, Traumatisme de l'oeil, Traumatisme des yeux
German Augenverletzung NNB, Augenverletzung, Augenverletzungen, Verletzungen, Augen-
Portuguese Lesão ocular traumática NE, Lesão ocular traumática, Lesões traumáticas oculares, Lesões Oculares, Traumatismos Oculares
Spanish Lesión traumática del ojo NEOM, lesión traumática del ojo (trastorno), lesión traumática del ojo, Eye injury, Ocular injury, Injury of eye, injuria ocular, Lesiones traumáticas oculares, Lesión traumática del ojo, Lesiones Oculares, Traumatismos Oculares
Japanese 眼球外傷, 眼外傷NOS, ガンキュウガイショウ, ガンガイショウ, ガンガイショウNOS, 外傷-眼, 眼外傷, 眼の創傷, 眼の損傷, 眼部外傷
Swedish Ögonskador
Czech oči - poranění, Zranění oka, Poranění oka, Poranění oka NOS, oči - zranění
Finnish Silmävammat
Russian GLAZA RANY I TRAVMY, GLAZ, RANY I TRAVMY, ГЛАЗА РАНЫ И ТРАВМЫ, ГЛАЗ, РАНЫ И ТРАВМЫ
Croatian OČNE OZLJEDE
Polish Urazy oka
Hungarian Ocularis sérülések, Szemsérülés, Szemsérülés k.m.n.