General Medical Information

Penetrating Injuries

Jean Edwards Holt

After an eye has been penetrated, immediate and long-term treatment is administered by an ophthalmologist. Accurate diagnosis and referral without manipulation or further examination are essential in managing these injuries. If foreign bodies are partially extruding from the eye, the diagnosis is evident. The foreign body should be left intact and removed in the controlled environment of an operating room. A key to the diagnosis of penetrating trauma is a peaked or teardrop pupil. If the pupil is not round and is pulled to one side, the examiner should suspect a penetrating injury and treat the patient with extreme care. The combination of lid laceration and hyphema also suggests penetration. For transporting a patient with an open eyeball, an aluminum shield is taped or a cone made from x-ray film or a plastic drinking cup is placed over the involved eye to avoid pressure than can cause extrusion of intraocular contents. Tetanus prophylaxis is appropriate, as with any laceration.