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editorial
. 2005 Oct;18(55):101–104.

Table 2.

Ocular signs and their implications following ocular trauma

Structure Appearance and associated features Implication
Lids Lacerations of lid margins
Puncture wounds
Involvement of medial canthus
Will require accurate repair
Check for globe perforation
Check for canalicular damage
Conjunctiva Sub-conjunctival haemorrhage Usually harmless, but exclude perforation if the IOP is low
Sclera Grey or brown discolouration on sclera Check for scleral perforation or laceration
Cornea Foreign body
Abrasion
Multiple staining areas following arc welding
Laceration with iris prolapse
Remove foreign body
Treat with antibiotic and pad
Treat as for an abrasion
Will require urgent repair
Anterior chamber Blood in the anterior chamber – hyphaema Usually resolves with conservative treatment; if secondary glaucoma, lower IOP with diamox
Pupil Peaked
D shaped – Iris dialysis
Check for laceration with iris prolapse, and refer for abcission repair
Manage conservatively but watch for secondary glaucoma
Lens Iris tremor – probable lens dislocation
White lens
Usually requires removal
Lens damaged resulting in a cataract
Red reflex No or poor red reflex Possible vitreous haemorrhage
Proptosis Swollen lids and protruding eye Medial wall blow out fracture with air in the orbit, orbital contusion or sub-periosteal haematoma
Endophthalmos Eye looks smaller – sunken-in globe Inferior wall blow-out fracture