Violence, falls or sports accidents can cause people to develop an eyeball contusion. While this is harmless in most patients, it can bring serious complications in other cases, so an eyeball contusion should be treated as soon as possible.
What is an eyeball contusion?
An eyeball contusion is an injury in the area of the eyeball, which is also called contusio bulbi in the technical language and can be based on different causes. A distinction is made between a mild and severe eyeball contusion and the rather rare eyeball tear. The symptoms of an eyeball contusion include a slight swelling in the area of the eyeball as well as a usually occurring conjunctival hemorrhage, which manifests itself in a reddening of the conjunctiva. Likewise, depending on the severity of the injury, the lens, retina, or bulbar wall may also sustain damage. In these cases, the patient should be referred to an eye clinic immediately because complications such as cataracts or glaucoma, as well as retinal edema and inflammation of the iris, among others, can occur.
Causes
Many different causes can underlie an eyeball contusion. However, mainly the eyeball contusion is caused by strong impact of force in the area of the eyeball. In the same way, injuries during sports can also contribute to the development of an eyeball contusion. Here it is mainly the ball sports such as tennis, squash or golf, where the balls can hit with a very high force in the area of the eyeball. Furthermore, a fall on the eye can also trigger an eyeball contusion. Less commonly, bruising occurs when foreign objects, such as rocks, wood chips, or corks, hit the eyeball at high velocity in everyday situations.
Symptoms, complaints, and signs
An eyeball contusion is characterized by pain and temporary deterioration of vision. The impairment of vision depends on the severity of the contusion. Double vision may also occur temporarily. The eyelids turn red and swell. At the same time, there is also swelling of the area around the eye. Colloquially, this is referred to as “violets”. If the conjunctiva is also affected, the eyes can sometimes no longer be opened. In some cases, bleeding into the interior of the eye may occur. As a consequence, the intraocular pressure may increase. Also a tear of the iris, a detachment of the retina, a clouding of the lens or even a displacement of the lens are possible. Furthermore, depending on the injury, bone fractures also occur in the bony eye socket. The most easily fractured part is the floor of the orbit. This limits the mobility of the eyeball. This, in turn, also produces double vision. In some cases, the muscle responsible for constricting the pupil is damaged. As a result, the pupil is no longer round and the different incidence of light can thus no longer be adjusted. When the lens is involved, there is often a star-shaped corneal opacity. Generally, eyeball contusion is associated with severe pain and swelling, red as well as itchy conjunctiva. The pain is more severe and prolonged the more structures are destroyed.
Diagnosis and course
Depending on the affected components of the eye, the symptoms and course of an eyeball contusion differ. In most cases, however, there is always swelling of the eyelids, which may be accompanied by severe pain. In addition, the conjunctiva often shows a swelling and redness, which can be attributed to increased blood flow. Corneal edema may also develop, and intraocular pressure may be increased. In many cases, the pupil may also be distended due to the injured iris sphincter, which normally controls the pupil constriction function. In such a case, a correct reaction of the pupil to light incidence is no longer possible. If an eyeball contusion results in a tear of the iris root, double vision may also occur as a symptom of the injury. In severe cases, a complete rupture in the bulb wall occurs under the possible leakage of the optic nerve.
Complications
In most cases, eyeball contusion does not cause any other symptoms or complications. The symptom should still be treated by a doctor, as the eye is a very sensitive organ that can be easily damaged. Often, after an eyeball bruise, a swelling appears on the eye. This can be cooled and in most cases goes away on its own after a few hours. Due to increased blood flow, the eye appears red, which is also a common symptom. It is not uncommon for vision to deteriorate briefly after the eyeball contusion, and veil vision or double vision may occur. However, as long as these symptoms disappear within a few hours after the eyeball contusion, no medical treatment is necessary. If the accident is severe or if the eye is hit, the bone may be fractured. This must be treated immediately in an eye clinic. If the eyeball contusion also damages the retina, this can lead to permanent vision problems. In most cases, these can be corrected with the help of a laser. Symptoms often do not appear until several days after the eyeball contusion. If the patient is not sure whether a symptom is dangerous or not, a doctor should always be consulted to prevent subsequent damage from the eyeball contusion.
When should you see a doctor?
After falls or sports accidents, a doctor should always be consulted. Especially injuries to the eye such as the eyeball contusion must be treated medically, because otherwise serious complications can occur. For this reason, it is recommended to go immediately to the family doctor or hospital with a bruise of the eyeball. If the eye bleeds profusely or is painful, it is best to call an emergency physician. Emergency medical assistance is especially necessary in case of visual disturbances or even loss of sight in the affected eye. Conjunctival hemorrhages and swelling of the eyeball should also be treated quickly. With a serious eye injury must immediately go to the eye clinic. There, the intraocular pressure is first stabilized and then appropriate treatment – usually surgery or laser surgery – is initiated. If a suture opens after treatment or the eyeball begins to bleed again, the doctor in charge must be consulted. Visual disturbances such as veil vision or double vision must be clarified immediately in an eye clinic.
Treatment and therapy
After the incident of an eyeball contusion, appropriate therapy should be started as soon as possible. Therefore, a presentation of the problem must be made relatively quickly in an eye clinic or eye practice, in which first of all the increased intraocular pressure is counteracted by medication. Based on the severity of the injury, a decision is then made as to which form of therapy is most suitable for recovery from the contusion. For example, if there is an injury to the retina, in most cases this is removed by laser surgery. Similarly, if there is a tear in the eyeball, surgery must be performed as soon as possible and the patient must then be given antibiotics to prevent infection in the area of the eyeball. Again, if there is a fracture of the bone of the eye socket, it is usually repaired by surgery after an X-ray diagnosis. In this case, bone plates made of metal are inserted to counteract the damage. In the case of minor injuries to the back of the eye, an examination is again usually only necessary after about 7 days, since in this case the symptoms do not appear until some time after the incident. In addition, to prevent possible secondary damage, steady follow-up examinations are mandatory in all cases.
Outlook and prognosis
The prognosis in the case of an eyeball contusion is strongly linked to the severity of the contusion. In this regard, a mild contusion in this area, which recedes within hours and also leaves no discomfort, deserves a significantly different consideration than, for example, an eyeball contusion associated with a tear. Thus, in the case of a mild bruise (redness of the eye, temporary slightly altered vision), the prognosis is good. Normal vision will return and the eye will also heal. Nevertheless, an ophthalmologist should be consulted, because in rare cases even small injuries and those that are overlooked can lead to serious complications.In more serious cases, the speed of medical observation and treatment is crucial. A torn or detached iris, an injury to the pupil, etc. can usually be corrected surgically. In most cases, there are no late consequences to worry about. This is different if the optic nerve has been damaged (tears or bruises in this area), or the macula (“yellow spot“) has been affected. Here, for example, tears or hemorrhages may occur. Injuries to the optic nerve and the fundus of the eye, mean in most cases a permanent impairment of visual acuity and can also result in blindness in the affected eye. In addition, late effects (retinal detachment, cataract, etc.) are possible, which is why the eye should be examined regularly. Headaches due to adjustment problems of the pupil, occur after such an accident.
Prevention
It is not very easy to specifically prevent an eyeball contusion. Merely wearing protective goggles when doing woodwork or similar activities, for example, helps shield the eye from approaching foreign objects and thereby prevent a possible eyeball contusion. In the car, on the other hand, seat belts and airbags protect against the development of a contusion. Furthermore, the use of force should be avoided in all situations and, when playing sports, the respective game balls should be handled as carefully as possible.
Aftercare
An eyeball contusion can present in varying degrees of severity, so follow-up care is essential in particularly severe cases. Often, a mild to moderate eyeball contusion is accompanied by severe discoloration around the eye. If pressure is applied to the affected area, the person complains of a very uncomfortable pain. In case of a very severe bruise of the eyeball, it may even result in a fracture. In such a case, regular visits to an appropriate doctor are very important and significant. This is the only way to ensure and guarantee that the fracture grows together properly. Even in the later course of healing, subsequent visits to the doctor are mandatory. Many affected individuals stress the site too early, causing it to fracture repeatedly. Only an appropriate follow-up examination can determine when the affected area is 100 percent capable of bearing weight. Mild to moderate bruises usually subside completely on their own. However, if the contusion is severe, regular examinations should be performed. Only in this way can unnecessary complications and unexpected complaints be detected at an early stage and treated accordingly. If such examinations do not take place, it may possibly lead to permanent consequential damage that cannot be subsequently healed 100 percent.
What you can do yourself
Since the eye is an extremely sensitive organ that can be easily damaged, an eyeball contusion should always be examined and treated by a doctor. In parallel with medical treatment, the patient can follow some self-help tips to help the eye recover. After an eyeball contusion, there are usually unpleasant symptoms such as swelling on the eye, a red eye due to increased blood flow, as well as veil vision. In order for the swelling of the eye to subside, cooling of the eye area is recommended. Cooling pads, cooling gel pads or cooled cucumber slices provide a quick remedy. Applying cooled tea pads to the eye can also have a positive effect on swelling. The tannins contained in the pads stimulate the metabolism of the lymph glands and subsequently reduce the swelling. In most cases, the swelling goes down on its own within a few hours. The medicinal plant arnica is also recommended for the treatment of bruises, as it has anti-inflammatory and analgesic properties. Wearing protective goggles can shield the eye from dangerous external influences to be able to prevent further eyeball bruising.
