1. TMA Department of eye diseases
Ocular traumas

2. Types of Eye Injury
There are a great variety of possible eye injuries but they tend to fit into the following basic types.
Blunt ocular traumas
Penetrating ocular traumas
Non-penetrating ocular traumas
Chemical eye injuries
Minor superficial eye injuries:
corneal abrasions
corneal and conjunctival foreign bodies
conjunctival lacerations
Eyelid injuries
Orbital injuries and fractures
Burns of cornea, conjunctiva and eyelid

3. Penetrating eye injuries
Distribution
Burns
Penetrating eye injuries 6 2
Non-penetrating
eye injuries 10 % 80
Blunt injuries

4. Blunt trauma of soft tissues and orbit
Injuries are divided by localization:
Blunt traumas of soft tissue and orbit
Closed fractures of orbit

5. Blunt traumas of soft orbital tissues
Signs:
- Subconjunctival haemorrage
- Haematoma of eyelids
- Absence of ocular movements

6. Orbital fractures - diplopy - enoftalm absence of ocular movements
signs:
- diplopy
- enoftalm
absence of ocular
movements

7. Orbital fractures а b c
a) Fractura of medial wall of the eye ( emphyzema of eyelids)
b) Fracture of lateral and inferior walls of orbit of right eye
с) Fracture of the superior wall of orbit, haematoma of eyelids

8. First-aid tactics
First aid for injuries of surrounding soft tissues: on-site imposition of cold for 1-2 hours (ice, wet wipes).
Maintaining hemostatic vasoconstrictors (menadione, vitamin K, Ascorutinum calcium chloride 10%).
Immediately send to ophthalmologist.

9. Blunt injuries of eye (contusion)
Divided according to severity:
Mild - complete recovery
Medium - small residual symptoms do not affect visual function
Severe - there are large morphological and functional disorders
Very severe - Rough morphological changes, loss of function  

10. Blunt injuries of the eye
Mechanism of eyeball contusion (schematic view)

11. Blunt injuries of the eye
Signs:
Subconjunctival haemorrage
Corneal erosion
Hyphaema
Haemophthalm (vitreous haemorrhage)
Iridodonezis (trembling of iris)
Mydriazis
Subluxation of lens
Iridodializis (detachment or tear of the iris)
Choroidal or retinal ruptures
Retinal detachment
Avulsion of an optic nerve

12. Choroidal or retinal ruptures
Ruptura of the pupillae
Oedema of the cornea and hyphema

13. Blunt injuries of the eye
Iridodializis
Dislocation of the lens

14. Blunt injuries of the eye
Choroidal ruptures
Choroidal ruptures and partial haemophthalmos

15. Horoidal or retinal ruptures
Traumatic avulsion of optic nerve
Retinal detachment

16. Blunt injuries of the eye
Subconjunctival ruptures of eye

17. First-aid tactics
Instillation into the conjunctival sac of antibiotics or sulfa eye drops
Anesthesia (local and general)
Easy aseptic bandage
Immediately send to ophthalmologist

18. Injuries of surrounding tissues
By localization injuries are divided into:
Injuries of eyelids
Lacrymal ducts injuries
Foreign bodies

19. Injuries of eyelids Lacerative crush wound of lower eyelid
of upper and lower eyelids

20. Lacrymal ducts injuries
Laceration of the lower eyelid, with injury of lacrimal duct

21. Foreign bodies of the orbit
Wooden foreign body is located in the right orbit and labyrinth (MRI)

22. First-aid tactics Tetanus toxoid
Washing the wound with disinfectant solutions
Parenteral (i/m) administration of antibiotics
Easy aseptic bandage
Immediately send to ophthalmologist

23. Wounds of an eyeball Divided by localization: Corneal wounds
Scleral wounds
Corneoscleral wounds
By penetrating of external walls
Penetrating injury
Non-penetrating injury
Penetrating injuries are divided into 2:
With intraocular foreign body
With exit of intraocular tissues from the wound

24. Wounds of an eyeball
Penetrating injury of cornea, absence of anterior chamber
Penetrating injury of cornea, anterior chamber is present

25. Eyeball injuries Penetrating injury of cornea with exit of iris
Penetrating corneaal wound complicated with lens opacification

26. Eyeball wounds Penetrating wound of sclera with exit of iris
Corneoscleral penetrating injury with foreign body

27. Penetrating scleral wound with foreign body.
Injuries of an eyeball
Penetrating scleral wound with foreign body.
Borders of cornea are adapted, penetrating wound with foreign body in anterior chamber.

28. First-aid tactics Tetanus toxoid
Washing the wound with disinfectant solutions
Parenteral administration of antibiotics
Binocular aseptic bandage
Immediately send to ophthalmologist

29. Treatment tactics Performed by ophthalmologist in specialized clinics:
X-ray of the orbit in the front and lateral projections
X-ray of orbit by Komberg – Baltin
Primary surgical treatment of wounds
Reconstructive operations routinely if necessary.

30. Severe complications after penetrating wounds of the eyeball
Injuries of eyeball
Severe complications after penetrating wounds of the eyeball
Endophthalmitis
Panophthalmitis
Sympathetic ophthalmia

31. Thermic and chemic burns of eyes
Burns of eyelids and conjunctiva are
divided by severety
I (mild) degree - redness and swelling
II (average) degree – bubbles
III (severe) degree - ischemia and necrotic zone
IV (very severe) degree - necrosis

32. Thermic and chemic burns of eyes
Classification by severety:
I (mild) degree – hyperemia of eye tissues, oedema, superficial corneal erosion.
II (medium) degree – deep corneal erosion, oedema, ishchemisation of conjunctiva and limbus area
III (severe) degree – in addition to the above mentioned corneal opacification like misted glass in the necrotic zones
IV (very severe) degree – porcelain cornea, total necrosis of conjunctiva, perforation

33. Medium degree of chemical burn of corneal layer
Thermic and chemic burns of eyes
Medium degree of chemical burn of corneal layer
Mudium degree of chemical burn of conjunctives. Ischemic zone of lymbic area

34. chemical burns of the eyeball is extremely severe
Кўз олмаси термик ва кимёвий куйишлари
chemical burns, severe lens
chemical burns of the eyeball is extremely severe

35. Кўз олмаси термик ва кимёвий куйишлари
chemical burn extremely severe. complications of cataract lens
chemical burn extremely severe. edematous cataract, secondary glaucoma

36. Thermic and chemic burns of eyes
Very severe thermic burn
Very severe thermic burn

37. Very severe thermic burn of eyeball and surrounding tissues
Thermic and chemic burns of eyes
Very severe thermic burn of eyeball and surrounding tissues

38. Thermic and chemic burns of eyes
Severe theromochemical burn of an eyeball. 1 month after the injury.
Very severe thermochemical burns, complicated cataract

39. First-aid tactics Removing of burn agent
Washing the conjunctival sac during minutes.
Using buttered solutions
Immediately send to ophthalmologist In the hospital:
Anesthesia
Washing of lacrimal ducts
The introduction of autologous blood under the conjunctiva
In case of severe burns, tetanus toxoid injection
Disinfecting, vitamin solutions
Parenteral injection of antibiotics
Binocular aseptic bandage

40. Thermic and chemic burns of eyes
the outcome of burns mild to moderate favorable
burns of moderate and severe usually leave behind changes require surgery
children with complications from burns of moderate and severe group are entered in the prevention of ocular pathologies and for a long time kept under medical observation

41. Prophylaxis of ocular traumas
Prevention consists of two stages: The first step, i.e. Primary prevention - preventive measures among the population at home, on the streets, in schools, kindergartens. The second stage, i.e. secondary prevention - early diagnosis, urgent measures to actively integrated medical and surgical treatment to help to prevent dangerous complications such as purulent and phacogenic uveitis, metallosis, hypotension eyeball and sympathetic ophthalmia.