Introduction

At least 90 out of 100 of eye injuries could be prevented. Eye injury is a leading cause of monocular blindness (blindness in one eye), and is second to cataract as the most common cause of visual impairment in the world. Most eye injuries occur in persons under thirty years of age (57%). Persons receiving an eye injury are on average aged 29 years.

Eye injuries most often include chemicals in the home, workshop and tool parts, battery acid, sports accidents, fireworks, over-exposure to ultra violet (UV) radiation, and the use of toys and games without supervision. 20% of eye injuries are work-related, with 95% occurring among males working in construction.

The National Society to Prevent Blindness reports that almost 40,000 eye injuries are related to sports and toys, but the number may be as high as 100,000. Many athletes have lost their careers because of eye injuries. While many athletes and sportspeople protect their heads with helmets and their bodies with pads, few protect their eyes.

Common Eye Injuries and Symptoms

Blunt trauma accounts for most sports-related eye injuries. The extent of eye damage depends on the size, hardness, and speed of the blunt object, and the force directly to the eye. Complications of blunt trauma include orbital blow-out fracture, orbital and lid contusions, iris injury, ruptured globe, traumatic iritis, (inflammation of the iris) subconjunctival bleeding, hyphema, retina bleeding, vitreous bleeding, choroidal rupture, retinal tears, and retinal detachment. Traumatic opitic neuropathy that injures the optic nerve may occur after closed head trauma. Signs of an orbital fracture include swelling, bruising, pain, especially with movement of the eyes, double vision that disappears when one eye is covered, and eyelid swelling after blowing the nose. Symptoms of iritis include deep aching pain, excessive tear production and light sensitivity. Optic nerve injury usually causes instant blindness. Symptoms of retinal detachment include a sudden or gradual increase in either the number of floaters, which are little "cobwebs" or specks that float about in your field of vision, and/or light flashes in the eye. Another symptom is the appearance of a "curtain" over the field of vision.

Hyphaema (blood clot in front chamber)	Right iridodialysis from blunt trauma

Blunt trauma from a paintball
Normal (pre-shooting) condition	Condition at time of shooting
Subsequent condition with post-traumatic cataract	Condition following lens replacement
Post accident condition

Penetrating injuries are rare but may occur even with large projectiles. Such injuries range from mild abrasions to serious lacerations.

Perforating eye injury	Penetrating injury - Iris prolapse

Orbital "foreign body" injury occurs from anything that gets into the cornea or orbit of the eye, including small pieces of wood, metal or plastic. Symptoms depend on where the foreign body is embedded, but include tear-production, pain, double vision, light sensitivity or a feeling of something in eye.

Subtarsal Foreign Body	Metal Corneal Foreign Body
Iron Foreign Body Embedded in the Vitreous

Corneal injuries or abrasions occur when an object gets into the eye and scratches the cornea. Symptoms of corneal abrasion include feeling that something is in the eye, tear-production, blurred vision, eye pain when exposed to bright light, and spasm of muscles around the eye area.

Corneal Laceration	View Into Eyeball
Side View of Eyeball with Eyelids

Radiation injuries occur after over-exposure to ultraviolet light during activities such as water sports, snow skiing, welding, and using sun-tanning booths. The most common radiation injury is ultraviolet keratitis, which is sunburn to the cornea (also called flash burn). Symptoms include pain, light sensitivity, redness and a feeling that something is in the eye. Solar retinopathy occurs after looking into the sun for an extended period. The primary symptom is decreased vision.

Chemical burns to the eye occur as a result of a splash of liquid getting into the eye or from aerosol use. The most common symptoms of chemical burns are pain and burning. The eye may also become red, or the eyelids swollen.

Prevention of Eye Injuries

Prevention is the first and most important way to avoid serious eye injuries.

Prevention tips:

Keep a pair of goggles in the home, land and car

Always check spray nozzles before using household chemicals

Wash hands well after handling chemicals

Check for debris, rocks, stones, low-hanging branches before using a lawnmower or trimmer

Look around the home for potential hazards to eyes, such as protruding objects, sharp corners, etc.

Keep adults' and children's fingernails short

In the industrial workplace, wear appropriate safety eyewear always. Welders, plumbers, construction laborers, machine operators and carpenters should learn about safety eyewear for their occupation. Polycarbonate lenses are best.

Wear sunglasses that block both UVA and UVB rays to prevent radiation injury from UV light. Always wear special goggles when using a tanning bed. Higher UV exposure occurs on snow, sand, and water, concrete and in high altitudes and low latitudes. UV radiation is highest between 10 am and 4 pm and highest in spring and summer.

Children and adults should use sunglasses if they are involved in ANY contact sport, or sport that involves use of a racquet, bat or other equipment such as a hockey stick. Sports eye protectors with polycarbonate lenses should be worn for sports such as basketball, racquet sports, soccer, baseball fielders, lacrosse and field hockey. Boxing, wrestling and other full contact martial arts sports have a high risk of serious eye injury. Thumbless gloves may reduce the number of boxing eye injuries. Contact lenses offer NO protection when participating in sports.

There are NO safe ways for non-professionals to use any fireworks, including sparklers. Use of legal or illegal fireworks is strongly discouraged due to the very high numbers of eye injuries that occur.

Make sure gifts that you give to small children do not have sharp, protruding or projectile parts. Darts, bow and arrows, and guns can cause severe eye injuries or blindness.

To prevent further damage to the eye after an injury, seek medical care immediately. Never rub the eye, apply ointment, or remove an object from the eye. Flush chemical injuries with water or saline (salt) solution.

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