Triage Of Ocular Trauma, Ocular Emergencies

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Ocular Trauma

Triage is the process of determining the priorities for action in an emergency and of establishing the order in which to carry out acts of medical assistance. Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries. During trauma soft tissues and bony structures around the eye may be involved.

Ocular trauma is the cause of blindness in about half a million people worldwide. Trauma is the most important cause of unilateral loss of vision, particularly in developing countries.

1. Treat on Site and Refer immediately

Chemical Injury

Chemical Injury may be from Acid or Alkali. Which need immediate irrigation of the ocular surface using the Normal Saline, if normal saline is not available to irrigate with clean tap water, refer immediately after irrigation.

Unremovable Corneal or Conjunctival Foreign Body

If there are any objects seen on the cornea (transparent parts of the eyeball) or in the conjunctiva, don’t try to remove it hardly at home. You need an immediate visit to the eye hospital for foreign body removals from eyes.

 

2. Refer Immediately

After an injury to the eye if patients have developed the following signs and symptoms they need an immediate reference to the eye hospital.

  • Decreased Visual Acuity
  • Irregular Pupil
  • Severe Pain
  • Corneal or Scleral laceration
  • Hazy Cornea
  • Severe lid swelling
  • Proptosis
  • Hyphema
  • Absent of Red Reflex
  • Suspected Intra Ocular Foreign body
  • Lid Laceration

3. Refer within 24 hours

If there are the followings signs and symptoms after the ocular trauma in the eyes, you have to refer to Eye Hospitals within 24 hours.

  • Pain
  • Photophobia (Difficulty to see on light)
  • Diplopia (Double Vision)
  • Large Corneal abrasion
  • Moderate conjunctival chemosis but normal vision
  • Suspected orbital wall fracture
  • F.B sensation but no foreign body visible

How can you prevent ocular trauma?

You can prevent ocular trauma by wearing safety goggles or glasses during works, playing sports. Wear proper safety measures such as a helmet having a polycarbonate glasses face mask or wire shield while playing high-impact sports.

References: American Academy of Ophthalmology publication

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