Mechanism and Emergency Management of Blast Eye/Orbital Injuries

Sabri T Shuker

Disclosures

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

In This Article

Expert Commentary

Blast injury management in general and eye/orbital blast injuries specifically should claim more attention and interest among ophthalmologist and other related specialties. Hundreds of thousands of people are losing their vision due to penetrating, perforating and ruptured eyes because modern vitreoretinal techniques not are being performed when needed, due to a lack of experience and/or equipment.

The likelihood of a person's vision being restored has a direct correlation to the immediate management of the eye injury; having the right eye patch, eye cleansing lotion and antibiotics and the combination of vitrectomy and antibiotics in managing post-traumatic endophthalmitis are critical.

Blast intraocular foreign body constitutes a significant portion of ocular trauma. The lethality to the eye has increased, largely attributable to the use of large amounts of high explosives that produce huge numbers of tiny fragments. With this increase in ocular trauma, penetrating intraocular trauma accounts for 31–85% of significant injuries to the eye.

Understanding the pathophysiology of blast injuries to the retina and vitreous as well as new vitreoretinal surgical techniques will help in the management of traumatized eyes with blast wave and penetrating foreign body more predictable in advanced centers and should be offered to all victims all over the world. With the help of the WHO and Ophthalmology Associations, this area of ophthalmology can receive the increased attention it currently lacks.

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