Eye contusion, blunt bulbus trauma, contusio bulbi
Blunt force in the area of the eyeball (bulbus) or the orbit (orbita) causes a contusion of the eyeball.
How common is an eyeball contusion?
Subdivision into slight, more severe, more severe eyeball contusions and tear of the eyeball (eyeball rupture). This is however very rare. It causes pain and, depending on the severity of the contusion, a deterioration of vision.
Temporary double images are possible. There is redness and swelling of the eyelids and a swelling of the area around the eye, the so-called “violet”, is observed. The conjunctiva (conjunctiva) can also be affected, so that opening the eyes is sometimes no longer possible.
Bleeding into the interior of the eye can lead to an increase in intraocular pressure, a tear of the iris, a detachment of the retina, clouding of the lens or even a lens shift. Likewise, a contusion of the eyeball can lead to fractures of the bony orbit. Most frequently, the bottom of the orbit is affected, which is very thin and therefore breaks most easily (“blow-out fracture“).
In this fracture, the mobility of the eyeball is restricted and double images are seen. Often the pupil is no longer round because the muscle responsible for the narrowing of the pupil (iris sphincter) is damaged and no longer functional. As a result, it is no longer possible to adjust to different light incidence.
If the lens is involved, a contusion of the eye can lead to a so-called contusion rosette. This can be recognized by a star-shaped cortical opacity of the lens. It is also possible that the lens is twisted out of its normal position (lens luxation).
Since the eyeball contusion is usually the result of a direct or indirect impact on the eye itself or the area of the face around it, pain is inevitable. Depending on which parts of the eye are affected and how severe the pain is, the intensity of the pain also varies. Almost always, however, the eyelids swell up, which in itself causes severe pain.
The conjunctiva also swells and becomes red and itchy due to the increased blood circulation, which is also sometimes accompanied by severe pain. The development of corneal oedema increases the intraocular pressure, which can also be very unpleasant and painful for the patient. In summary, the more severe the eyeball contusion is and the more structures have been damaged, the stronger and longer lasting the pain will be.
The increased intraocular pressure is reduced with medication and controlled by constant follow-up examinations. Retinal injuries are usually treated with laser surgery. Smallest injuries of the ocular fundus sometimes occur only after a few days, therefore a follow-up examination is necessary after 7 to 10 days after the accident.
For this purpose, the pupil is dilated with medication to facilitate the examination of the retina. The most severe form of eyeball contusion, the rupture of the eyeball (eyeball tear), must be treated surgically as soon as possible and treated with antibiotics to prevent an eye infection (inflammation). In the case of fractures of the orbit, a clarification with X-ray and usually subsequent surgery with the insertion of metal bone plates is necessary.
If a contusion of the eyeball is so severe and pronounced that it is dangerous to the eye itself and thus to the ability to see, a homeopathic procedure is not advisable. You should therefore always go to an ophthalmologist and have the bruise professionally examined before relying on alternative healing methods. There are, however, some natural healing herbs that have proven effective in cases of bruises and contusions of the eyeball.
First of all, there is Symphytum, or comfrey in English. Hamamelis, the Virginian witch hazel, also has a vasoconstrictive effect and can thus support the natural healing process of the eye. Arnica also helps against bruises and sprains of all kinds.
Applied externally, it relieves pain and inhibits the release of inflammatory substances. Contusions of the eyeball are caused, for example, by fist hits, snowball throws, champagne corks, in agriculture by cow horn blows, when chopping wood by logs jumping away or when mowing the lawn by stones, when falling while under the influence of alcohol (due to lack of protective reflexes), but also by sports injuries such as a tennis ball, golf ball or squash ball. Consistent wearing of protective goggles (also during sports), belt and airbag in the car, keeping champagne bottles away from the face when opening them, avoidance of violence Since a contusion of the eyeball is in the majority of cases caused by a blow on the eye itself or the cranium, it is almost always an acute case.
This also makes a fast and immediate treatment necessary. Under no circumstances should the affected patient postpone the visit to the doctor for longer than absolutely necessary, since with the passing of time, structures in and around the eye are permanently damaged and can no longer be reconstructed. The development of oedema in the eye must be contained as a priority, so that the increased intraocular pressure does not pinch the optic nerve and cause it to die.
Depending on how the extent of the severity of the injuries to the eye can then be determined by the doctor, appropriate treatment must be initiated. Injuries to the retina are corrected, for example, by laser technology. Possible bone fractures must be treated surgically.
If only small injuries to the eyeball are involved, a control examination after about seven days is usually sufficient to detect possible consequential damage or to diagnose late damage. Depending on the individual case, the doctor must then decide on the further procedure and adjust the therapy accordingly. How quickly the eye heals even then depends entirely on age and general condition as well as the severity and extent of the damage to the structures and is difficult to assess.
The fastest possible presentation at an eye clinic or ophthalmological practice is crucial for the success of the therapy of an eyeball contusion. In most cases, vision can be maintained at least partially or even completely and only in the case of very serious injuries is blindness or severe visual impairment to be expected despite surgery. In some cases, further surgical interventions may be necessary in order to optimise vision in the course of the operation.
Bleeding or tears in the area of the macula (centre of vision, point of sharpest vision, at the back of the eye) and an injury to the optic nerve usually cause a significant permanent reduction in vision. In the years following the accident, the intraocular pressure must also be checked regularly, as it can increase with a time lag. A retinal detachment or clouding of the lens (cataract) is possible with a time delay after the accident.
Possible consequences of an eyeball contusion are also reading difficulties and associated headaches, a remaining dilated pupil and a resulting light sensitivity. A contusion of the eyeball should never be taken lightly, as small damage to the eye can lead to serious impairment of vision if left untreated. Therefore, it is first necessary that a doctor examines the affected eye for possible fluid accumulation, bleeding and defects of the retina, damage to the lens, the iris and the eyeball itself.
Changes in the retina lead to disturbances of vision in the short and long term and are particularly dangerous if they are located centrally in the retina, as this is the point of sharpest vision. A resulting loss of vision may be permanent under certain circumstances. The eye contusion can also lead to clouding of the lens (cataract) and an increase in intraocular pressure (which in turn promotes the development of glaucoma).
Particularly strong blows to the eye area can also cause bone fractures, the so-called blow-out fractures. Here the bone of the orbit breaks, so that the eyeball can no longer be held in its original position and the eye muscles that move it can be trapped or even torn off. The eye then has little or no movement and double vision occurs.