Penetrating Eye Injury

Key history
Key examination/signs
Initial management
Investigations
Referral

Key history

• Nature of incident
• Time of incident
• Anaesthetic readiness
• Tetanus status

Key examination/signs

• DO NOT remove penetrating object
• DO NOT place pressure on the eye trying to examine or place pad
• DO vision in affected and fellow eye
• LOOK FOR
  • Corneal/scleral would
  • Irregular pupil
  • Iris prolapse into would
  • Shallow anterior chamber
  • Blood in anterior chamber
  • Extensive sub-conjunctival haemorrhage

Initial management

DO NOT remove penetrating object

DO NOT

• Place pressure on eye trying to examine or placing pad.
• Facial lacerations can be sutured but leave lid lacerations to be done in theatre at time of globe repair.

DO

• Cover with protective shield
• Keep nil by mouth

GIVE

• Intravenous antibiotics (Kefazolin) plus oral ciprofloxacin
• Tetanus prophylaxis as per protocol
• Anti emetics if nauseated and pain relief

Investigations

CT scan of orbits and brain if available to rule out foreign body and orbital or intracranial involvement

Referral = Urgent