Eye Injuries

General Exam ~ inspect for swelling and deformity ~ palpate orbital rim ~ inspect globe of eye ~ inspect conjunctiva ~ determine pupil response (PERRLA) ~ determine visual acuity blurred or double vision blurred or double vision floating black specs floating black specs flashes of light flashes of light

Orbital Hematoma “Black eye” MOI: a blow to the eye that may injure surrounding tissue and produce capillary bleeding

S/Sx: redness and swelling around the eye Tx: ~ ice ~ rest from activity if vision is distorted ~ do not blow nose for at least 2 hours after initial injury

Foreign Body in Eye DO NOT RUB EYE If foreign body is in lower lid, depress lower lid and wipe out with cotton swab If foreign body is in upper lid, pull the upper eyelid over the lower eyelid as the subject looks down--let tears flush out object

Once the object has been removed the eye should be flushed with a commercial eyewash

If the object has become embedded, both eyes should be patched and the athlete sent immediately to a doctor

Torn/Detached Retina Def: The retina is a nerve layer at the back of your eye that senses light and sends images to your brain. A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. MOI: Direct blow to head or eye

S/Sx: –Flashing lights –Floating specks –A shadow in the periphery of field of vision –A gray curtain moving across field of vision Tx: –An untreated detached retina will almost always result in blindness –An athlete with a history of recent blow to head or eye with these symptoms should be sent immediately to an optometrist or ophthalmologist

Hyphema Def: blood in the anterior chamber of the eye MOI: blow to the anterior aspect of eye S/Sx: you will see blood in the chamber-- blurred vision Tx: this is a major injury and should be referred immediately to a doctor

Blowout fracture Def: fracture of the floor of the orbital socket MOI: direct blow to the eye

S/Sx: –Swelling –Hemorrhaging –Diplopia (double vision) –Restricted ocular movement (vertical) –Eye may appear to be positioned down and back –Numbness of cheek TX: control bleeding, patch with sterile gauze, ice, send to doctor

Caution Remember that any blow that is forceful enough to injure the eye may also cause a concussion. Be sure to rule out a concussion when doing an eye evaluation.