Pediatric Ocular Injuries
Betty R. Klein MD1
Marvin L. Sears MD1
1 Yale Eye Center for Clinical Research, PO Box 3333, New Haven, CT 06510
Although an ophthalmologist should be consulted for virtually all eye injuries, the first person to see the patient or talk to the parents can be of enormous value in preventing or limiting the sequelae of the injury and subsequent visual loss. This article provides a practical guide to the management of pediatric ocular injuries resulting from trauma and addresses the incidence of ocular trauma in children and the potential for preventing these injuries.
Potential Injuries
The eye is an anatomically and physiologically complex system that is easily disrupted by sharp or blunt trauma. For this reason, subtle signs of external trauma may indicate serious intraocular injury. The cornea and vitreous are avascular and can be the sites of fulminant infection by even the most indolent of organisms introduced by injury. The crystalline lens is readily dislocated or may opacify after blunt or penetrating trauma. The diaphanous retina is attached to the inner surface of the eye by hydrostatic and osmotic forces. The smallest perforation can lead to total retinal detachment. The highly vascular uvea, which lies beneath the retina, can undergo massive hemorrhage after sharp or blunt trauma. The retinal arteries may occlude after sudden increases in intraocular pressure, which sometimes accompany intraocular or intraorbital hemorrhage.
