Mechanism and Emergency Management of Blast Eye/Orbital Injuries

Sabri T Shuker

Disclosures

Expert Rev Ophthalmol. 2008;3(2):229-246. 

In This Article

Hyphema

The casualty in figure 5 suffered blunt blast injury although there were no peppered penetrating injuries in the face and ocular region from blast particles because the patient was exposed to the indoors blast effect (as defined earlier). This resulted in a bilateral circumorbital ecchymoses, subconjunctival hemorrhage, hyphema, vitreous hemorrhage and nasal bleeding, which indicated that the orbital wall fracture clinically was not displaced. The management is dependent on the cause and severity of the hyphema. Frequently, the blood is reabsorbed over a period of days to weeks. During this time, the ophthalmologist carefully monitors the intraocular pressure for signs of the blood preventing normal flow of the aqueous through the eye's structures Figure 5.

Bilateral severe subconjunctival hemorrhage; vitreous hemorrhage and hyphema.

Proptosis may indicate a retro-bulbar hemorrhage. Pupillary distortion may be associated with an open globe. Decreased motility on one side may be caused by an open globe. Other causes include muscle injury, orbital fracture and orbital hemorrhage.

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