Eye injury

“ DISEASES OF THE EYES Albugo, or Spot in the Eye, Opacity of the Cornea In consequence of a blow, stroke of a whip, or similar injury, an inflammatory action is set up in the eye, the result of which is an effusion of serum between the lamina of the outer coating of the eye, which renders the cornea or clear part of the eye, whitish or opaque in spots, interfering materially with the sight and usefulness of the organ. ”

“ It is equally important to protect our eyes from injury, another leading cause of vision loss. Each year, more than 2.4 million eye injuries occur in the United States. By using protective eyewear when working with machinery or chemicals, playing sports, or engaging in other recreational activities, we can help prevent irreparable loss of sight. ”

“ Frequently all endeavours to avert untoward results are unavailing, and the functions of the organ are more or less impaired—the cornea may become opaque, the iris may protrude, the pupil may become irregular, contracted, or obliterated—the crystalline lens may lose its transparency, amaurosis may occur from injury of the retina, the humours may be evacuated, and the eye sink in its socket. The entrance of a large foreign body into the orbit may displace the globe, and cause it to protrude between the eyelids: in such a case the body should be removed and the ball gently replaced ”

“ Healthy eyes even should never be used to read fine print or by a dim light. Serious injury may be caused by an imprudence of this kind. Reading upon the cars is also a fruitful source of harm. The lens, striving to adapt itself to the incessantly varying distance of the page, soon becomes wearied. Whenever the eyes begin to ache, it is a warning that they are being overtaxed and need rest.
Objects that get into the eye should be removed before they cause inflammation; rubbing in the meantime only irritates and increases the sensitiveness. ”

“ Injury now alleged to cause the disability was a scale of paint in the eye and it is the opinion of the surgeon in charge that this would give an intraocular hemorrhage such as was present in the right eye. ”

“ The early pain may be ascribed (1) to injury to the nerves of the ciliary body and iris, especially when the laceration of those structures is considerable, as our clinical experience and our specimens alike show it sometimes is; (2) to hæmorrhage from the vessels of the ciliary body, the iris, the choroid or the retina: such hæmorrhage may produce pain in two ways— (a) by dissecting up sensitive structures, and (b) by increasing the tension of the eye; and (3) to the rapid production of early glaucoma. There are several ways in which we may conceive that such a glaucoma might be produced. ”

“ After injury to the eye, after operations, and in some forms of internal inflammation, we attach great value to the uniform support of the closed eyelids, and we increase this in many instances by the application of a bandage. ”

“ It is a disease which is very common in workhouse schools, orphan asylums and similar establishments. Unlike ophthalmia of new-born children, it is difficult to cure, and a total separation of the diseased from the healthy children should be effected.
About one-half of those who are blinded by injuries lose the second eye by sympathetic ophthalmia. It is a constant source of danger to those who retain an eye blinded by injury. Blindness from this cause can be prevented by the removal of the injured eye, but unfortunatelySympathetic inflammation. ”

“ A careful focal illumination of the eye will enable the operator to see and remove the smallest particles without injury. Subsequent treatment is that of wounds.
ACUTE KERATITIS. INFLAMMATION OF THE CORNEA. Extension from conjunctivitis, wounds, foreign bodies, bites, stings, blows, infections, filaria. Symptoms: eye tender, closed, epiphora, red, pannus, photophobia, congested sclera, opaque or ramified red cornea, or diffuse red, exudation, suppuration, corneal abscess, ulcer, perforation, prolapsus iris, panophthalmia. Focal illumination. Recovery. Permanent 379cicatrix or opacity. ”

“ When the globe is burst by a blow with a blunt object, the sclerotic usually gives way, and as the rupture takes place from within outward, there is less risk of infection than in punctured wounds. The lens may be extruded through the wound, and the iris prolapsed. If the rupture is large, the conjunctiva torn, and the globe collapsed from loss of vitreous, the eye should be removed without delay. If sight is not entirely lost and there is no marked collapse of the globe, an attempt should be made to save the eye. ”

“ In either case the eyeball is protruded, and the cornea is exposed to irritation and may become inflamed and ulcerated. The optic nerve may be lacerated, and complete and permanent loss of vision result. Sometimes the ocular muscles and nerves are damaged, and deviation of the eye or loss of motion in one or other direction results. The globe itself may be injured. Foreign bodies lodged in the orbit, so long as they are aseptic, may give rise to little or no disturbance, and are liable to be overlooked. The Röntgen rays are useful in determining the presence and position of a foreign body. ”

“ When inflammation has gone on in the eyelid, little knots like pin-heads form, producing a feeling as if sand were in the eye. Afterwards these knots grow large and swell the eyelid, and at times the matter in them grows hard, and seems to take up a lasting abode in that tissue. Strong and destructive liquids or powders are sometimes applied, that so affect the whole substance of the eye as to cause blindness. Nothing of this nature is required at all. First, the skin of the head must be dealt with. ”

“ In a few hours violent inflammation supervened, and continued several weeks, in spite of the most vigorous and energetic treatment, its principal seat being the optic nerve, and subsequently the iris. The inflammation was at length overcome, but vision was not restored; and the irritability in both eyes was so great as to render it absolutely necessary not only to avoid all attempts to use them, but also to exclude them from the light. The sight of the right eye was entirely, and, as I feared, irrecoverably gone; its pupil contracted almost to the size of a pin's point, and immoveable. ”

“ No little thing causes more pain and discomfort than something in the eye. Do not rub to remove a foreign body from the eye, as this is likely to injure the delicate covering of the eyeball. First, close the eye so the tears will accumulate, these may wash the foreign body into plain view so that it may be easily removed. If this fails, pull the upper lid over the lower two or three times, close the nostril on the opposite side and have the patient blow his nose hard. If the foreign body still remains in the eye, examine first under the lower and then the upper lid. ”

“ They often follow the infliction of a blow or wound. The patient’s sight speedily declines, without any known cause; there is pain in the forehead, temple, and eyeball; the ball protrudes, perhaps slightly, and at first is not otherwise changed; but on careful examination a dimness can be perceived deep in the eye. The opaque body approaches the pupil and fills it, and may in this state be mistaken for disease of the crystalline lens; but the tumour soon pushes forward the iris, and fills the anterior chamber. ”

“ In adults it often seems to be produced by the action of strong reflected light, as by exposure to intense fires in forges, glasshouses, &c., or by a dependent 280position of the head, accompanied with exposure to light. People advanced in life are most subject to the disease.29 It is not an unfrequent consequence of internal ophthalmia, and almost invariably follows the slightest wound or most delicate puncture of the lens: it often occurs after slight injury of the lens or its capsule, inflicted during attempts to form an artificial pupil. ”

“ When we use the eye too long, or in too bright a light, it becomes bloodshot. The increased action of its vessels and nerves gives rise to a sensation of fatigue and pain, requiring us to desist. If we relieve the eye, the irritation gradually subsides and the healthy state returns. But, if we continue to look intently, or resume our employment before the eye has regained its natural state by repose, the irritation at last becomes permanent, and disease, followed by weakness of vision, or even blindness, may ensue. ”

“ It is known as interstitial keratitis, and takes the form of a gradual, slow clouding of the clear, transparent convex surface of the eyeball, the cornea, through which the light passes to reach the lens. While the process is active, the child is made miserable by an extreme sensitiveness to light, the eye is reddened, and there is pain and a burning sensation. When the condition passes off, the child may scarcely be able to distinguish light from dark, to say nothing of reading, finding its way about, or doing fine work. ”

“ There is reason to believe that a degree of blindness, and even complete amaurosis, has been caused by wound of the eyebrow, the superciliary nerve having been contused, wounded, or otherwise injured; or the functions of the eyeball may be disturbed by concussion from injury. Paralysis, also, of the levator palpebræ superioris, or of several of the muscles belonging to the eyeball, may follow injury of the forehead and neighbouring parts, from either laceration or concussion of the nerves. ”

“ When the eye is inflamed, great light becomes eminently painful, owing to the increased irritative motions of the retina, and the consequent increased sensation. Thus when the eye is dazzled with sudden light, the pain is not owing to the motion of the iris; for it is the contraction of the iris, which relieves the pain from sudden light; but to the too violent contractions of the moving fibres, which constitute the extremities of the optic nerve. ”

“ The commonest visual defects are, first, inflammation of the cornea, or imperfections of the lens—the cornea is often so scarred as to make vision imperfect; second, myopia, or progressive shortsightedness, a condition in which the axis of the eye gradually grows longer. This lengthening is accompanied by stretching of the eyeball, and such children always run the risk of the inner and most important part of the wall of the eye, the retina or nerve layer, being torn away, and blindness resulting. ”

“ We soaked off the dressings with some boric solution that I had procured from the Operating Hut. There was not even a single basin in the tent to which the man had been brought, not to mention a nurse or medicines. After a while we got the eyes open a tiny bit so that they could be examined and washed out a little, and then the doctor blew out: “It’s a perfect crime to send a man down here in this condition, look at this puncture wound of this eye, and see what a terrible condition his eyes are in. A whole lifetime of blindness will probably be the result.” ”

“ The large number of sensitive nervous filaments renders the visual organ very impressible to bodies that cause irritation, as dust, or intense light. This compels us to use due care to shield the eye from the influence of agents that would impair or destroy vision.
2d. Although particles of dust, when in contact with the delicate parts of the eye, induce severe pain, yet these parts may be cut in surgical operations, and the patient’s sufferings are not as great as when an incision is made in the skin to remove a small tumor. ”

“ It should contract promptly in light and dilate as quickly in darkness. Place the patient before a window, cover one eye so as to exclude light, then cover the other eye with the hand and quickly withdraw. The pupil should be widely dilated when the hand is withdrawn and should promptly contract, and it should actively widen and narrow alternately until the proper accommodation has been secured. Any failure to show these movements implies a lesion in the brain, optic nerve, or eye which impairs or paralyzes vision, interferes with accommodation or imprisons the iris. ”

“ Most of them are attended with pain and other annoying symptoms, and some cause loss of vision. Some are cured by internal means; others require surgical operations; and the cure is either complete and permanent, or palliative and temporary. Some destroy the organ, and others, still more malignant, cause extinction of life. All require much attention and care.
Of Ophthalmia, or Inflammation of the Eye.—The symptoms and appearances of ophthalmia vary much according to the particular texture or textures affected. ”

“ In extreme cases the eyes protrude from their sockets to such a degree that the eyelids cannot be closed, and injury may thus arise to the constantly exposed eyeballs. Apart from such risk, however, the vision is rarely affected. ”

“ The pupil must thereafter be kept dilated by atropia to obviate adhesion of the iris to the wound and the eye must be kept in comparative darkness and aseptic. If active inflammation sets in, cold, astringent or iced dressings may be called for, while if the swelling of the lens is threatening it should be at once extracted. If the eye becomes unduly tense, puncture of the cornea is indicated, and the relief of tension will sometimes start a tardy solution into renewed activity. ”

“ One can trust implicitly to the extraordinary reparatory power of the eyelids, yet so unsightly is any distortion of these parts, that the greatest pains must be taken to obviate loss of substance, or unevenness or puckering in healing. The points to be mainly sought for are the perfect coaptation of the divided edges, and the restraining of the patient from interrupting the healing process and breaking loose the forming adhesions, by rubbing the eye. ”