Corneal Blunt Trauma

• Is usually not sight-threatening injury.

Clinical Features

• Symptoms: acute blurry vision, foreign body sensation, photophobia or ocular pain.
• Signs:
  • May be isolated or associated with bruising or swelling of surrounding ocular tissues
  • Mild blunt trauma may cause epithelial disruption without stromal or endothelial damage
  • Severe blunt trauma may cause endothelial damage, Descemet's membrane tears with resulting severe corneal edema or laceration

Work Up

• Thorough eye examination includes dilated fundus examination to rule out intraocular foreign body and damage to intraocular structures.
• Seidel test to rule out open globe injury.
• Ultrasonography.
• Exam under general anesthesia may be necessary for exploration and/or repair of suspected rupture globe.

Management

• Eye patch or bandage contact lens for corneal abrasion.
• Prophylactic topical antibiotics.
• Topical steroids may be useful in cases of significant inflammatory reaction.
• Hypertonic saline or 5% NaCl ointment or drops to resolve corneal edema.