eye foreign body injury

Introduction

Introduction to foreign body injury Foreign body injuries of the eye are more common, and can be classified into metal foreign matter and non-metal foreign matter according to the nature of the foreign matter. Most foreign objects are iron, steel magnetic metal foreign bodies, and non-magnetic metal foreign objects such as copper and lead. Non-metallic foreign bodies include glass, gravel and vegetal (such as eucalyptus, wood) and animal (such as hair, thorn) foreign matter. Foreign bodies of different nature have different damages and treatments in different parts of the eye. Intra-ball foreign bodies are eye injuries that seriously threaten vision. The damage of foreign bodies includes mechanical damage to the structure of the eye by foreign bodies, chemical and toxic reactions, transvaginal infections and consequent sequelae, for example, foreign bodies passing through the cornea, crystals. Can cause corneal perforation, pigmented membrane incarceration, corneal opacity and cataract; through the pigmented membrane or retina can cause intraocular hemorrhage, iron foreign body dissolved in the eye oxidation, has obvious toxic effects on the retina, iron oxide and tissue protein formation Insoluble ferritin, deposited in various tissues, manifested as brown stagnation called ocular rust, which can cause vision loss, foreign matter brought into pathogenic microorganisms, can cause intraocular infection, cause blindness, clinical manifestations of foreign bodies in the ball often The above various factors are related. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: iridocyclitis cataract retinal detachment glaucoma

Cause

Eye foreign body injury

Most foreign objects are iron, steel magnetic metal foreign bodies, non-magnetic metal foreign objects such as copper and lead, non-metallic foreign bodies including glass, gravel and plant (such as sputum, wood) and animal (such as hair, thorn) foreign bodies, etc. Foreign bodies of different nature have different damages and treatments in different parts of the eye.

Prevention

Eye foreign body injury prevention

It is a serious eye injury, which is easy to cause blindness. It must be prevented by prevention. In the society, we should publicize the knowledge of preventing eye injuries. We must establish safety protection measures at the factory, establish and improve rules and regulations to prevent accidents, schools and Parents should carry out safety education for children, do not play sharp toys, and strictly prohibit the use of explosives. If there is trauma, seek medical attention.

Complication

Eye foreign body injury complications Complications, iridocyclitis, cataract, retinal detachment, glaucoma

Intraocular foreign bodies persist for a long time, and some complications often occur. At this time, the diagnosis can be made according to the complications, and then confirmed by other methods. The common complications are as follows:

1. eyerous rust (siderousbulbi): iron foreign matter persists for several days to several months, and rust can occur. It first appears around the foreign body, and then spreads and spreads to various tissues in the eyeball, showing a brownish-yellow granular stagnation. The cornea is mostly in the stromal layer, with more peripheral parts, the iris is brown, and the iris is atrophied for a long time. After the adhesion, the pupil is moderately scattered, the light response is weakened or disappeared, and the crystal first appears brown particles or under the anterior capsule. Round, oval spots, after the cortical opacity, diffuse brown yellow, vitreous turbid browning brown, retinal susceptible to its invasion and degeneration, manifested as vision loss and visual field reduction.

2. Eye chlorosis (ocularchalcosis): When copper is abnormally entered into the eye for several hours, the increase in copper content can be found in the aqueous humor, but the clinical appearance of rust is often several months or more after the injury. The higher the copper content, the heavier the copper rust. If the copper content is more than 85%, the damage is serious. Pure copper can cause acute aseptic suppuration. When the foreign body is wrapped by the mechanized tissue, the copper rust is relatively light, and the iris is small. Copper rust often does not occur in copper rust. The copper rust of the cornea is most obvious in the posterior elastic layer of the peripheral part. The typical performance of the Keyser-Fleischer ring is often present in the clinic. The iris also appears yellow-green, the pupil is moderately enlarged, the response is slow, and the crystal is also It can present yellow-green fine-like deposits on the surface of the subcapsular cortex and posterior capsule. The typical change of the crystal is a sunflower-like cataract. The middle part of the cortex under the anterior capsule has a gray-yellow disk-like opacity. The valve is turbid, and it can develop into an all-white cataract. The vitreous body has a golden yellow bright reflective group, which resembles the reflection of the copper foreign body itself, but moves rapidly as the direction of the light changes. When the slit lamp is microscopically examined, there are many fine deep yellow-green particles that flutter with the movement of the eyeball. Golden light is seen on both sides of the blood vessels on the retina. The yellow-green particles everywhere can gradually disappear, and the lesions of the macula It becomes a grayish white atrophy zone, the crystal becomes a milky white tide, and some copper foreign matter (the one with a very high copper content) can gradually move forward and form a sterile suppuration. Finally, the anterior part of the eyeball breaks through the sclera and discharges the eyeball. Formerly known as the corner.

3. Iris ciliary body inflammation: Unexplained monocular iridocyclitis or total uveitis in which long-term reactions occur, should be asked in detail about the history of trauma, and other tests to confirm or rule out the presence of foreign bodies in the eye.

4. Cataracts: Cataracts of unknown origin in young adults, sometimes caused by foreign bodies in the crystal or foreign matter passing through the crystal.

5. Other complications: unexplained vitreous opacity with organic membrane or cord, secondary retinal detachment of one eye, secondary glaucoma with unexplained monocular, etc., should also consider the possibility of retention of foreign bodies in the eye, and corresponding Check.

Symptom

Symptoms of foreign body injury, common symptoms, eye pain, corneal foreign body, eye irritation, arrotropy, tear, cellulitis, orbital bleeding

1. Foreign objects outside the ball

1. Eyelid foreign bodies, more common in blast injuries, can make the upper and lower eyelids covered with fine powder of gunpowder, dust and sand.

2. Conjunctival foreign bodies, common dust, coal dust, etc., more hidden in the lower ditch of the seesaw, sacral and half-month wrinkles, foreign bodies rubbing the cornea can cause irritation.

3. Corneal foreign body, with coal dust, iron filings are more common, there are obvious irritations, such as tingling, tearing, eyelids, etc., iron foreign matter can form rust spots, plant-like foreign bodies can easily cause infection.

4. Orbital foreign bodies, common mites have metal shrapnel, airsoft bullets, or wood, bamboo fragments, may have local swelling, pain, if combined with purulent infection, can cause sputum cellulitis or sputum.

Second, the ball inside the foreign body

Intra-ball foreign bodies are eye injuries that seriously threaten vision. The damage of foreign bodies includes mechanical damage to the structure of the eye by foreign bodies, chemical and toxic reactions, transvaginal infections and consequent sequelae, for example, foreign bodies passing through the cornea, crystals. Can cause corneal perforation, pigmented membrane incarceration, corneal opacity and cataract; through the pigmented membrane or retina can cause intraocular hemorrhage, iron foreign body dissolved in the eye oxidation, has obvious toxic effects on the retina, iron oxide and tissue protein formation Insoluble ferritin, deposited in various tissues, manifested as brown stagnation called ocular rust, which can cause vision loss, foreign matter brought into pathogenic microorganisms, can cause intraocular infection, cause blindness, clinical manifestations of foreign bodies in the ball often The above various factors are related.

Examine

Eye foreign body injury inspection

History of trauma

Such as knocking metal history, blast injury, etc., a small number of patients may have no conscious history of trauma.

2. Clinical manifestations

Often accompanied by the symptoms and signs of perforation of the eyeball, according to the size, nature and injury of the foreign body, the clinical performance can be varied in the morning and evening.

3. Examination of wounds and wounds

It is found that perforated wounds are an important basis for the diagnosis of foreign bodies in the ball, such as corneal wounds or full-thickness scars. Corresponding iris parts have small holes, and crystals are localized and turbid, indicating that foreign bodies enter the eye. Scleral wounds are difficult to find. Eye examination and auxiliary inspection methods are judged.

4. Imaging or electromagnetic method inspection

X-ray film, ultrasound, CT scan or magnetic resonance imaging can be used to detect foreign objects of different nature. These methods have their own advantages. They can be selected according to the conditions. For magnetic foreign objects, electronic sound foreign matter locators can also be used to help diagnosis. .

Diagnosis

Diagnosis and differentiation of foreign body injury

diagnosis

Diagnosis can be based on clinical manifestations.

Differential diagnosis

Need to identify with other mechanical eye injuries such as contusions, penetrating injuries and non-mechanical ocular trauma.

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