Blunt Eye Trauma

10 sources cited
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What is Blunt Eye Trauma?

Blunt eye trauma is also known as ocular trauma. It refers to an injury to the eye or areas around the eye caused by forceful impact, injury, or physical attack with a dull object.

Blunt eye trauma can include damage to the eye, bones around the eye, and the eyelid. 

Ocular injuries damage the eye due to the sudden compression and indentation of the eyeball that occurs at the moment of impact.

Blunt eye trauma can lead to various complications, including:

  • Globe rupture (bursting of the outer membrane of the eye)
  • Retrobulbar hematoma (blood congestion in the soft tissue behind the eyeball)
  • Retinal detachment
  • Orbital fracture (broken bones of the eye socket)
  • Hyphema or bleeding in front of the eye
  • Foreign body entrapment
  • Traumatic glaucoma (damage to the optical nerve)
  • Corneal abrasions (cuts on the clear, protective window at the front of the eye)
  • Vitreous hemorrhage (bleeding into the jelly-like filling of the back part of the eye)
  • Cataract

Blunt trauma can potentially lead to loss of vision. Therefore, any trauma to the eye should be considered an emergency.

In 2001, an estimated 1.9 million people in the U.S. had an eye injury that required treatment. In 2013, there were about 5.3 million cases of foreign bodies in the eyes worldwide.

What Causes Blunt Eye Trauma?

Blunt eye trauma is caused by a sudden forceful impact to the eye. 

Common causes of blunt eye trauma include:

  • Sports (especially ice hockey, soccer, softball, and baseball)
  • Car accident
  • Job-related injury (especially drilling, hammering, or working with cars)
  • Fighting or interpersonal violence
  • Falling
  • Children’s games such as BB guns and firecrackers

Young men are more likely to develop blunt eye trauma. 95% of ocular trauma injuries occur in men under 30 years of age, often caused by interpersonal violence.

Blunt eye trauma is more likely to occur in the home, followed by the workplace. In older patients, blunt eye trauma is most often caused by falls. 

Symptoms of Blunt Eye Trauma

Symptoms of blunt eye trauma depend on the severity of the injury.

Common mild symptoms include:

  • Minor pain
  • Bruising
  • Swelling
  • A black eye
  • Trace amounts of blood over the white part (sclera) of the eye
  • Edema or buildup of fluid in the eye

Severe symptoms of blunt eye trauma that indicate a critical injury has occurred include:

  • Any blood over the colored part (iris) of the eye
  • Vision changes 
  • Difficulty moving the eye
  • Pain with eye movements
  • A large amount of blood in the white part (sclera) of the eye
  • A change in pupil size or shape
  • Severe pain in the eyeball
  • Light sensitivity
  • Blurred vision
  • Double vision 
  • Eye deformity
  • Deformity of the eye socket
  • Numbness around the eye
  • Abnormal upper eyelid movement
  • A foreign object embedded in the eye
  • Degenerative Eye Diseases

Blunt Eye Trauma Management

Blunt eye trauma should be treated within 4 hours from the onset of symptoms. This will reduce the risk of vision loss.

Patients who have sustained an eye injury should seek immediate medical attention at a hospital emergency room or urgent care facility. 

An emergency department physician will:

  • Examine the patient
  • Provide a visual acuity test
  • Treat superficial lacerations around the eye.

Attending clinicians will consult an ophthalmologist on call to assess the eye. If there is any possibility of vision loss, patients will be referred to an ophthalmologist for additional treatment. 

Tell your doctor exactly what happened to your eye. This is crucial for them to be able to provide the best treatment.

The doctor may use a slit lamp to examine the eye, including the cornea and optic nerve, and assess the damage. The doctor may take CT scans or X-Rays to rule out an orbital bone fracture and look for any foreign debris.

Immediate surgery or laser treatment can prevent permanent vision loss in the case of:

  • Retinal tear
  • Retinal detachment
  • Globe rupture

Sometimes the consequences of an eye injury may not become noticeable for months or years after the damage occurs. These late effects, including cataract, retinal detachment, or glaucoma, all may result in vision loss. Therefore, continued follow-up care is essential to preserve vision after an injury.

Treatment For Blunt Eye Trauma 

Treatment of blunt trauma depends entirely on the extent of the injury.

Treatment for mild blunt eye trauma includes:

  • Ice packs
  • Pain medicine
  • Reducing physical activities until the eye is healed

Treatment for severe cases of blunt eye trauma will also include:

  • Steroid eye drops to reduce inflammation
  • Glaucoma eye drops to reduce intraocular pressure
  • Antiemetics or anti-nausea medication
  • Antibiotic ointment
  • Wearing protective eyewear until the eye is healed
  • Surgery
  • Follow up eye examinations
  • Bed rest
  • Avoiding aspirin and ibuprofen, which can increase the risk of re-bleeding

Common Questions and Answers

Can blunt force trauma cause blindness?

Yes, blunt force trauma can cause blindness.

There are approximately 1.6 million people around the world who are blind from eye injuries. There are an additional 2.3 million people with bilateral low vision and almost 19 million with unilateral blindness or low vision from eye injuries.

Can you go blind from getting hit in the eye?

Yes, you can go blind from getting hit in the eye. The likeliness of developing blindness depends on the location of the hit and the velocity of the impact.

In one study, 10.7% of patients admitted to the hospital for eye trauma developed some blindness in the injured eye. 

Individuals who participate in high-risk occupations and sports should exercise extreme caution and always wear protective eyewear.

How do you know if you have permanent eye damage?

The most common indicators of permanent eye damage (retinal damage) include blindspots, color distortions, afterimages, blurriness, decreased center vision, and complete vision loss.

Can getting hit in the eye cause retinal detachment?

Yes, the force from blunt eye injuries can cause detachment of the retina.

How long does it take for trauma to the eye to heal?

Minor eye injuries can heal within 1 to 3 days, but more severe eye injuries can take several weeks or months to heal.

Do eyeballs heal themselves?

Minor blunt eye injuries can heal within a few days. An ice pack, pain medications, and rest are typically all that's necessary. However, more severe blunt eye injuries may require steroid eye drops, antibiotic ointments, or even surgery.

When should you go to ER for an eye injury?

Seek medical care if your eye is severely inflamed, painful to the touch, and/or is watering more than normal. Also, if you are having trouble seeing, go to the ER.

10 Cited Research Articles
  1. “Assessing and managing eye injuries.” Community eye health vol. 18,55 : 101-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1705680/ 
  2. Desai, P et al. “Incidence of cases of ocular trauma admitted to hospital and incidence of blinding outcome.” The British journal of ophthalmology vol. 80,7 : 592-6. doi:10.1136/bjo.80.7.592 https://pubmed.ncbi.nlm.nih.gov/8795369/
  3. Eye Injuries: Blow to the Eye. https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=sig57226
  4. Global Burden of Disease Study 2013 Collaborators. “Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.” Lancet (London, England) vol. 386,9995 : 743-800. doi:10.1016/S0140-673660692-4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561509/
  5. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Small objects in the eye: Do minor eye injuries heal better with or without an eye patch? [Updated 2020 May 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279583/
  6. Kent, Christopher. “Managing Serious Cases of Ocular Trauma.” Review of Ophthalmology, 18 Nov. 2008, www.reviewofophthalmology.com/article/managing-serious-cases-of-ocular-trauma
  7. “Mechanisms of Injury.” Indiana.gov, State of Indiana, www.in.gov/isdh/files/Mechanism_of_injury.pdf.
  8. Mohseni M, Blair K, Bragg BN. Blunt Eye Trauma. [Updated 2020 Jun 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK470379/
  9. Négrel, A D, and B Thylefors. “The global impact of eye injuries.” Ophthalmic epidemiology vol. 5,3 : 143-69. doi:10.1076/opep.5.3.143.8364 https://pubmed.ncbi.nlm.nih.gov/9805347/#:~:text=The%20global%20pattern%20of%20eye,year%3B%20750%2C000%20cases%20will%20require
  10. “Trauma to the Eye.” Chicago Medicine, 21 Mar. 2018, https://chicago.medicine.uic.edu/departments/academic-departments/ophthalmology-visual-sciences/our-department/media-center/eye-facts/trauma-to-the-eye/
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