Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Eye injuries

The area around the eye is constructed in such a way as to give the eye the greatest possible protection against external impact. Direct impact against the eye from a large object, such as a football, can result in bleeding and swelling in the eyelid and surrounding soft tissues, but seldom injures the eye itself. However, blows from small or pointed objects, such as elbows, fingers, sticks, rackets, squash balls, and pucks, can cause direct injuries to the eyeball. Most eye injuries are minor, but serious injuries need immediate attention to avoid loss of vision. Indications for which immediate contact with a physician is advised include:

– severe eye pain;
– double vision;
– loss of visual acuity;
– decreased field of vision;
– blood or blurring at the pupil or iris;
– abnormally shaped pupil;
– suspected penetrating injury or tear;
– decreased eye movements.

Inflammation and bleeding in the conjunctiva
The eye is relatively resistant to irritation, but swimmers can be affected by inflammation of the conjunctiva (which covers the whole of the eyeball) because of the chlorine in swimming-pool water. The complaint can also be triggered by oversensitivity or overexposure to sunlight. It is harmless, and the problems can be relieved by eye drops. Swimmers can prevent the complaint by using protective goggles.

Subconjunctival hemorrhage is probably the most common eye problem. It can occur from trauma to the eye or by spontaneous rupture of blood vessels due to a sudden increase in blood pressure from exertion. So long as no visual symptoms or prolonged photophobia are present, this injury will resolve spontaneously and no treatment is required. Subconjunctival hemorrhage can sometimes mask other, more serious problems; if these are suspected, a doctor should be consulted immediately.

Lid lacerations
Lacerations of the eyelids, especially those that involve the tear system at the inside corner of the eye,require meticulous repair. A doctor should be consulted immediately.

Corneal abrasions
One of the most common eye injuries in sport is a small scratch on the cornea (the clear central part of the eye covering the iris). The wound can be caused by a finger-nail, a foreign body in the eye, or a contact lens. The affected person complains of pain and a gritty sensation in the eye, especially in bright light and when blinking. Increased tear flow is a common symptom. If a wound on the cornea is suspected, a doctor should be seen for advice since the injury can affect the sight. The treatment is usually ointment or eye drops and rest; an eye pad may be applied for a day or so.

Bleeding into the anterior chamber of the eye .A blow to the eye with a blunt object can cause bleeding in front of the iris (hyphemia). The blood forms a
fluid level between the iris and the cornea at the bottom of the anterior chamber of the eye. The treatment of immediate bed rest, and sometimes bilateral eye bandaging for 5–6 days to control additional bleeding. The
injured person should see a doctor for examination and observation. The condition often heals without any permanent disability, but secondary glaucoma and blood-staining of the cornea are worrisome complications that may impair sight.

Detached retina
The retina can be partly detached by a hard blow to the eye, and this should be suspected if the injured person has impaired sight within a limited field of vision. The injury should be examined by a doctor.

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