Question

Enumerate the various consequences of a closed globe injury by a blunt object.

Hint:

Closed globe injuries can lead to serious complications, including retinal detachment and traumatic cataracts. Immediate assessment and imaging are crucial to determine the extent of the injury.

Answer 1

Step 1: Consequences of a Closed Globe Injury by a Blunt Object.
A closed globe injury refers to trauma to the eye in which the integrity of the outer layers of the eye is maintained (i.e., there is no rupture or penetration). Blunt trauma can lead to several serious consequences, including:
(1) Contusion of the Eye (Orbital Hematom:
- The trauma can cause bleeding within the eye or around the orbit, leading to a black eye (ecchymosis) and potential damage to the ocular structures.
- Blood may accumulate in the anterior chamber (hyphem or vitreous body (vitreous hemorrhage).
(2) Rupture of the Iris or Ciliary Body:
- Blunt trauma can cause damage to the iris or ciliary body, leading to iritis (inflammation of the iris) or cyclitis (inflammation of the ciliary body). This can result in painful red eyes and vision impairment.
(3) Retinal Injury:
- The force of the impact can cause retinal contusion or retinal edema. In severe cases, the retina may become detached (retinal detachment), leading to vision loss or even permanent blindness.
(4) Lens Dislocation:
- Blunt trauma can cause the lens to dislocate from its normal position. This is termed traumatic lens dislocation and may result in visual disturbances or even cataracts.
(5) Orbital Fractures:
- The impact can lead to fractures of the orbital bones, including the orbital floor or medial wall, leading to entrapment of extraocular muscles (e.g., muscle entrapment), causing double vision (diplopi and limited eye movement.
(6) Intraocular Pressure Changes:
- A closed globe injury can cause changes in intraocular pressure (IOP), either an increase (e.g., glaucom or decrease (e.g., hypotony), both of which can affect vision and require prompt treatment.