Treat­ing eye trauma

The eas­i­est way to pre­vent in­jury is to wear pro­tec­tive eye­wear such as gog­gles. We only have two eyes; the loss of even one is trau­matic and detri­men­tal. There is no way to re­place an eye or your vi­sion.

The Star Malaysia - Star2 - - HEALTHY EYES - Dr Liau Kok Liang

TRAU­MATIC eye in­juries are more com­mon than peo­ple think; ac­ci­dents hap­pen at work or even dur­ing play.

The most com­mon one seen by spe­cial­ists is a corneal for­eign body in­jury, where a mov­ing for­eign body ( most of­ten a tiny piece of metal) be­comes lodged in the cornea ( the trans­par­ent layer that forms the front of the eye).

This in­jury is of­ten seen among peo­ple who work with po­ten­tially dan­ger­ous ma­chin­ery, such as steel- cut­ting ma­chines, weld­ing equip­ment or even grass cut­ters, and who ne­glect to wear pro­tec­tive eye gear.

Corneal for­eign body in­juries also oc­cur dur­ing mo­tor ve­hi­cle ac­ci­dents, such as when a bro­ken glass flies into the per­son’s eye, and among chil­dren where the cornea is pierced with a pen­cil, for ex­am­ple.

“A corneal for­eign body can usu­ally be re­moved un­der lo­cal anaes­the­sia by us­ing a nee­dle and a slit lamp mi­cro­scope. The pa­tients are then pre­scribed with an­tibi­otic eye drops to pre­vent in­fec­tion in the eyes,” says Dr Liau Kok Liang, res­i­dent con­sul­tant oph­thal­mol­o­gist at Mahkota Med­i­cal Cen­tre.

Dr Liau ex­plains that a more dan­ger­ous in­jury oc­curs when the eye is cut by a sharp for­eign body trav­el­ling at high speeds, caus­ing a full thick­ness corneal lac­er­a­tion – where the sharp ob­ject cuts through the whole cornea to next lay­ers of the eye. The in­jury wors­ens if the for­eign body hits the lens of the eye.

“This can cause a trau­matic cataract, which can lead to loss of vi­sion. There is also a chance of bac­te­ria en­ter­ing the eye and caus­ing in­fec­tion,” he ex­plains.

Other in­juries in­clude where a blunt ob­ject ( such as a shut­tle­cock or, in cases of as­sault, a fist) hits the eye, caus­ing blood to pool in the eye, lead­ing to blurred vi­sion.

Dr Liau says that most of th­ese in­juries can be treated with oral and top­i­cal med­i­ca­tion. How­ever, if the in­jury is se­vere, it can lead to trau­matic glau­coma, which is where there is per­sis­tent high pres­sure in the eye­ball. This re­quires long- term treat­ment and sur­gi­cal in­ter­ven­tion in some cases.

Some­times, a force­ful im­pact can even lead to the eye­ball rup­tur­ing. “This type of trau­matic in­jury is more dif­fi­cult to treat and in most cases leads to com­plete vi­sion loss,” says Dr Liau.

An­other se­ri­ous eye in­jury is called intra- oc­u­lar for­eign body, where the for­eign body has pen­e­trated the eye­ball and rests on the in­ter­nal part of the eye­ball.

Treat­ment for this in­jury re­quires the use of a vit­rec­tomy ma­chine to re­move the for­eign body and su­ture ( sew close) the lac­er­a­tion.

Imag­ing tech­nol­ogy such as a CT ( com­puted to­mog­ra­phy) scan may also be used so that the sur­geon can de­ter­mine ex­actly what the in­jury en­tails.

“The eye is very small com­pared with other or­gans, so a 2mm ob­ject lodged in the eye is con­sid­ered quite big. There­fore, surgery on the eye re­quires mi­cro­scopic pre­ci­sion,” says Dr Liau.

Th­ese treat­ments are ad­min­is­tered by spe­cial­ists at hospi­tals in Malaysia, in­clud­ing Mahkota Med­i­cal Cen­tre. It is best to go to hos­pi­tal when such in­juries oc­cur in­stead of to your nor­mal gen­eral prac­ti­tioner.

Dr Liau stresses the im­por­tance of tak­ing care of your eye health. “Your eyes are not like your bones – they do not re­grow the same way. If you have a se­vere in­jury, you may never re­cover full vi­sion in that eye. Loss of vi­sion is usu­ally per­ma­nent,” he ex­plains.

This means that you will lose your abil­ity to per­form cer­tain tasks as your three- di­men­sional vi­sion is com­pro­mised. This may lead to you los­ing the abil­ity to work and to loss of in­come.

“The eas­i­est way to pre­vent in­jury is to wear pro­tec­tive eye­wear such as gog­gles. This goes not just for those work­ing with ma­chin­ery in a fac­tory but also the ev­ery­day per­son who does work around the house or is cut­ting grass in the gar­den,” he ad­vises.

“We only have two eyes; the loss of even one is trau­matic and detri­men­tal. There is no way to re­place an eye or your vi­sion. It is there­fore very im­por­tant to en­sure safety and pre­vent eye in­jury.”

For more in­for­ma­tion, con­tact Mahkota Med­i­cal Cen­tre.

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