ANTERIOR SEGMENT TRAUMA

Trauma to the anterior segment of the eye is commonly seen in day to day life. It can either be due to penetrating injuries or blunt injuries to the eye. These injuries if left untreated can lead to devastating consequences such as loss of vision or even threaten the patient’s life in cases of severe infection.

Anterior segment injuries consist of injuries to the anterior structures of the eye including the lids, conjunctiva, cornea, iris and the lens. Treatment options vary wildly due to a large number of factors ranging from regional location to injury severity. Mild trauma cases such as a small foreign body in the eye may only require in-office treatment, whereas extreme cases such as gunshot wounds require surgical care, sometimes requiring multiple surgeries. Some injuries to the anterior segment of the eye may have a very good prognosis if treated in time and appropriately. However certain injuries may prove difficult to completely treat leaving some residual effects of the injury. The prognosis of the patient depends on the extent of the injury and also the object by which the injury occurs in the first place.

A thorough immediate evaluation by an ophthalmologist is essential in order to judge the severity of the injury and to provide prompt treatment as and when required. Many patients of eye injuries need to follow up for re-evaluation several times after their initial treatment. The cause for this need of continuous monitoring is that injury can case secondary changes in the eye which may set in days to months after the injury. These secondary changes may include formation of a cataract, increase in the intraocular pressure or also disorders of the retina. The treatment of these sequelae of the original injury is as essential as the primary care given at time of the injury.

Penetrating injuries are most commonly seen in the work place, household injuries or road traffic accidents. In case of an open wound immediate care in the form of primary wound repair is of utmost importance to prevent any infections from setting in.

The most common source of blunt injuries is sports related.  The work place is the most common source of anterior segment trauma (45.1%). Most of these injuries can be avoided by use for special protective eye gear and proper handling and maintenance of machines and accessories. Sports injuries are the next most common source (14.75%). The can also be avoided by use of protective eye gear and also by fair game play and following the rules aptly. Household injuries can be avoided by keeping sharp or harmful objects away from children. Avoiding or minimizing use of firecrackers during festivals can also reduce the number of injuries.

A few first aid steps to be taken in case of such injuries:

Penetrating trauma

·         Do not touch/wipe eye

·         Do not apply any pressure on the eye

·         Do not apply any drops/ointment to eye

·         If any foreign body is present, do not attempt to remove it

·         Refer to an ophthalmologist immediately

Blunt trauma

·         Do not blow nose. Try not to sneeze/cough

·         Refer to ophthalmologist

Any kind of ocular trauma is a medical emergency and should be attended to by a doctor immediately.