Sharp objects eg glass, blade of knife often cause eyelid lacerations and may lacerate the cornea or sclera. Eyelid lacerations require careful repair to prevent long-term misalignment eg ectropion. Injuries at the medial end of the lid may injure the tear ducts and without appropriate repair lead to lacrimal obstruction.
Lacerations of the cornea or sclera may allow visible prolapse of the intra-ocular contents such as iris or choroid. Repair is essential though the risk of impairment or loss of sight is high.
Sharp objects travelling at speed can penetrate the eye and become lodged within it (intra-ocular foreign body/IOFB). Typical causes include hammering metal or glass fragments from a road traffic accident. These objects need to be identified and removed as there is a significant risk of loss of sight from the injury itself or subsequent infection.
Damage to the internal structures of the eye from penetrating injuries includes:
Objects may also become lodged within the orbit eg air-gun pellet.
Action
All injuries where there is a laceration visible or a possibility of intra-ocular or intra-orbital foreign body should be referred urgently to the eye emergency department.
