OCULAR TRAUMA

dr. Rahmat Syuhada,Sp.M

FAKULTAS KEDOKTERAN
UNIVERSITAS MALAHAYATI
BANDAR LAMPUNG
2017
 Ocular trauma

Actions that intentionally or unintentionally --> eye

injury or injuries that cause damage to the eyes,
eyelids, optic nerve and orbital cavity

This damage will leave a complication that disrupts the

function of the eye as the sense of sight.
 Etiology

1. Mechanical
a. Blunt trauma, for example, hit, hit by ball, bottle cap
b. b. Sharp trauma, such as kitchen knives, scissors, forks, and
carpentry tools.
2. Chemistry
a. Basic chemical trauma, such as, shampoo, floor cleaner, lime,
or glue.
b. Acidic chemical trauma : vinegar, acidic materials in the
laboratory.
3. Radiation
a. Thermal trauma : heat of fire, electricity, welding rays, sunlight.
b. Trauma of radioactive materials, such as radiation rays
 Mechanical Trauma

a. Blunt Trauma 2. Conjunctiva

1. Palpebra Konjunctival Edema

Subconjunctival Hematoma
3. Cornea 4. Uvea
Corneal Edema Iridodialysis

Cornea Erosion Hyphema

5. lens
- lens dislocation
- Lens subluxation.
- Luksasi Lens Anterior.
- Posterior Lens Luksasi.
- Vossius ring
6. Trauma Retina and choroid
- Edema retina and choroid
- Ablacio Retinal
- choroidal rupture

7. OPTIC NERVE TRAUMA

- Avulsion Papil Optic Nerve
- Traumatic optic neuropathy
8. LENS 10. Alienum Corpus (FOREIGN
- Cataract OBJECTS)
Management together with blunt
trauma.
- Dislocation of lens
Management together with the
involuntary eye blunt

9. Damage posterior segment

Management together with
involuntary eye blunt
11. MUSCLE extraocular
 Eye Movement Disorders. This
trauma can be caused by:
- abnormalities in the eye muscles
- abnormalities in eye muscle
innervation
- abnormalities in orbital tissue
more
 Symptoms
1. Bleeding or discharge from the eyes or
surrounding areas
2. Bruising around the eyes
3. Decreased visus in the sudden time
4. Diplopia
5. Red-colored eyes
6. Pain and stinging in the eyes
7. Headache
8. Eyes feel itchy, feels there is a wedge in the eye
9. Photopobia
 Diagnosis
1. Anamnesis
In the history it is necessary to know whether there is a
decrease in visus after injury or when injury occurs. The
onset of visus degradation is either progressive or sudden.

2. Physical examination
Physical examination performed complete ophthalmic
examination including visus examination, pupil reactions,
field of view, movement of extraocular muscles, intraocular
pressure, examination of slit lamp, fundoscopy and others
 CONSERVATIVE TREATMENTS / NO
OPERATION

1. Bedrest perfect (total bed rest)

2. The use of drugs
- Koagulansia
- Midriatika Miotika
- Ocular hypotensive Drug
- Corticosteroids and antibiotics
- Other medications (sedative is given when the patient
restless and analgesics in case of pain)

Operation
1. Paracentesis (remove fluid / blood from the front chamber of
the eyeball through a small opening in the limbus)
3. supporting examination
a. Ultrasonografi
b. CT-scan
c. Magnetic Resonance
Imaging
6. Trauma Retina and choroid
- Edema retina and choroid
- Ablacio Retinal
- choroidal rupture

7. OPTIC NERVE TRAUMA

- Avulsion Papil Optic Nerve
- Traumatic optic neuropathy
B. Trauma Penetrating Eye Ball

 Sharp eyesight ↓
 lower IOP
 Shallow chamber
 The shape and location of the low pupil
 Looks a rupture of the cornea or sclera
 There is a prolapsed tissue, such as a liquid eye, iris,
lens, glass body or retina
 conjunctiva kemotis
C. Trauma Sharp
 Etiology
Sharp trauma caused by sharp
objects or foreign objects into
the eyeball
 MANAGEMENT
When seen one of the signs
above or suspected
perforation of the eyeball,
then promptly carried topical
antibiotics, eyes closed, and
immediately sent to the eye
doctor to do the surgery.
 SIGNS AND SYMPTOMS
- Sharply declining eyesight
- Low pressure eyeball
- Shallow Bilikmata
- The shape and location of the
pupil changes
- Seen any rupture of the sclera
corneaatau
- There was a prolapsed tissue
(eye fluid iris, lens, glass body
or retina).
- Conjunctiva kemotis
1. Palpebra
Sores palpebra
- Complaints of pain, swelling
and bleeding.
- Inspection: it appears the
wound open and bleeding
- Treatment: cleaning
wounds, then sewn. If need
be augmented with
antibiotics, analgesics and
anti-inflammatory.
2. conjunctiva
- Bleeding: Treatment same
as involuntary eye blunt
mechanical.
- Rips 1 cm: No stitches,
antibiotics are given
locally.
- Rips more than 1 cm:
Stitched with cat gut or silk
thread of 0.5 cm between
each jahitan.Beri local
antibiotics for 5 days and
bandaging the eye for 1-2
days.
 Cornea
- Corneal erosion: Treatment
such as involuntary eye
blunt
- Penetrating injuries of the
cornea
- corneal ulcers
 Sclera
- Open sores or breaks
Treatment: The same with
penetrating wounds to the
cornea.
5. Sympathetic Phthalmia
 Phase irritation (Sympathetic
Irritation)
 Phase inflammation (Sympatetic
Inflamation)
6. BILIK EYES FRONT
 Management together with blunt
trauma.
7. IRIS
 Iris Often as a result of trauma.
II. TRAUMA CHEMICAL

trauma Acid
trauma Bases
III. PHYSICAL TRAUMA

 Light
 Fire (Treatment: Not unlike the disorder cause burns on
the skin of other body parts.)
 Blow Out Fracture
Treatment :
- Conservatives for 3 weeks to evaluate pending edema
and reduced ekhimosis
- When enoftalmus still visible, very disturbing diplopia
complaint: Operative.