Ophthalmic considerations in the severely injured patient

Certain eye signs are of critical importance with respect to determining the ocular status of a traumatized patient. Evidence of a penetrating injury to the eye dictates prompt and appropriate management in order to insure the best possible prognosis for useful vision. In such injuries, the presence of intraocular foreign bodies must be ruled out and skull radiographs are essential. Concussive or blunt injuries involving the orbit and globe can produce varying degrees and types of damage, and expeditious evaluation is advised. Protection of a globe that has been, or is suspected of being, ruptured or seriously injured by a protective pad and shield may mean the difference between the traumatized patient retaining useful vision or sustaining a permanent visual handicap. Prompt recognition of eye signs that signal the necessity for specialized ophthalmic medical or surgical management may be of inestimable value in preserving the sight of a severely injured patient.