Eye Trauma Video

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This video covers common eye trauma like corneal abrasions, lid lacerations, and globe rupture. This lecture is one of the longer videos in this series, but I think you’ll find it worth your time. I’ve presented a number of common ocular traumas that we see in ophthalmology (from corneal abrasions, to eyelid repair, open globe, lateral canthotomy, hyphema, and iritis). Each of these conditions I’ve captured on video, and so this presentation is very multimedia driven. Below you’ll see some of the captured snapshots.

Screen Captures from this Video:

Cornea Abrasion Epithelium
This graphic shows the epithelial loss of corneal abrasion. The cornea has 5 layers, and it’s the surface epithelial layer that is so easily rubbed off. Fortunately, this layer also regrows and heals quickly.

Staining cornea abrasion
Fleuroscein strips make it easier to check for corneal staining. Regular dye drops work well, but the fluid tends to pool at the bottom of the eyelid and makes spotting small abrasions difficult. Sometimes “less” dye is better.

Seidel
The Seidel Test for finding corneal laceration. This involves rubbing a strip of fleuroscein paper over a potentially leaking corneal wound to detect aqueous egress.

Dermabond cornea
Creating a dermabond patch to stop corneal leaks. This is an uncommon technique that I’ve used with good success on occasion.

Corneal glue
Corneal glue for a perforated cornea. I find this material hard to use.

Metal eye
A metal foreign body on the cornea. This finding is very common, and I see several patients a week with metal flakes stuck on the corneal surface. Many of these patients are grinding metal … usually wearing protective eyeglasses. The metal bits seem to get in their hair, then fall into the eye later and rust into place.

prosthetic cornea
KPro corneal transplant after chemical burn. These prostetic corneas work, and are sometimes the only option after failed corneal grafts.

pH
Checking the pH value after a chemical burn is important. Debris trapped in the fornices (under the eyelid) can cause continous pH imbalance, so keep checking.

Conjunctiva blood
A subconjunctival hemorrhage looks impressive, but is almost always harmless pooling of blood under the skin. They go away after a week or so.

Dellen
Dellen of the cornea from conjunctival hematoma. These occur when the conjunctiva swells (such as from a SCH hematoma or bad chemosis) such that an area of the cornea begins to dry. Classically, seen with thinning of the cornea without gross dye staining.

iritis
Iritis treatment involves steroids and dilating drops. Steroids get rid of the inflammation, while the dilating drops help with photophobia and help avoid iris synechae.

hyphema
Hyphema is a layering of blood in the anterior chamber of the eye. A “microhyphema” is when there is blood, but not enough to layer out.

blood in eye
Hyphema is treated similarly to iritis, with steroids and dilators. You need to watch out for pressure spikes … especially around days 3-5, as this is when iris clots begin to retract and rebleeding can occur.

floor fracture
Entrapment of the rectus muscle. This photo shows a medial wall break. The orbital floor is actually the bone that breaks most often.

entrapement
Forced ductions to detect inferior rectus entrapment. This photo shows soft ductions using tetracaine and a q-tip. However, this method has limited utility and you often need to use forceps and grab the eye at the limbus.

eyelid injury
Repair of a lid laceration using nylon sutures at the anterior and posterior lamella. You can see the plastic mono-canallicular stent in the punctum at the left edge of this photo.

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Dr. Timothy Root is a practicing ophthalmologist and cataract surgeon in Daytona Beach, Florida. His books, video lectures, and training resources can be found at:

25 COMMENTS

  1. Thanks so much for the videos; they have been very insightful and most helpful for my dissertation research, in observing an ophthalmologist in practice. Your benevolence is most appreciated.

    I must say, it is nice to see someone who loves what they do for a living and in remaining excited about their specialised subject matter.

    I will investigate your site further and I might even buy the book.

    All the best,

    Vicky

  2. Thank you for some fantastic videos with great explanations! I’m currently doing the ophthalmology course on the 6th year of medicine; and these videos have been such a great help! Keep up the brilliant work!

  3. I hope all teachers are like you.
    you’re one in a million.

    i already devoured all your videos , you have no idea just how helpful your teaching videos are to me.

    i’m reviewing for the ophthalmology board exams this coming april by the way.

    i’ve been serving as a general ophthalmologist here in far flung countryside in the philippines for 6 years now.

    thank you for a lot of pearls.
    God bless

  4. great work sir.

    iam an ophthalmology resident from india.

    your lecture series are real eye openers for all ophthalmologists.

    great work. keep publishing more.

  5. my,is salmoon muassi ,i got trauma on my lt eye, my pupil dilate,eye ball come on toward my nose side ,i have senstation than light touch my eye ,but still have no vission, my rt eye working properley, so please guide me who it can possible that i will see through my lt eye and it look lie my rt eye.please guide me ,my email add is ,,,, salmoonmunassi@yahoo,com,,,,,,,,,,,,,,,
    nazirarif@yahoo.com

  6. Thank you for these videos! I’m not in the medical field; just found your site while Googling topics of interest. I’m in the construction industry and was thinking while watching that these videos should be required viewing for our industry.
    Power tool use aside, so many times we go into areas where the eyes can be subjected to particulates, contaminants, or injury, all the while thinking we’re okay just because we’re not using a power tool.
    Seeing damaged eyes gave me renewed appreciation for these little gems in my head. Thanks again!

  7. I want to thank you deeply for the insight you have provided to me in my quest to better understand the recent injury that my brother is going through. I understand that this minimal source of knowledge does in no way make me a sudden eye expert but this and some other resource I have sought, I feel, helps me better understand what his type of injury involves as well as some of the questions I should be asking in our quest to prevent him from losing the eye all together. I will continue to do some research and keep watch for any future information you might have to share. Once again, I can’t thank you enough for the clarity it has given me.

  8. hello sir first of all i would like to thank you for the time and effort you put in to make these wonderfull and very much informative lectures.im a med student who can neither sink nor swim in opthalmology but after listening to ur lectures i can confidently swim in opthal topics.
    thanks a million for helping students like me….
    god bless u abundantly…

  9. hello sir first of all i would like to thank you for the time and effort you put in to make these wonderfull and very much informative lectures.im a med student who can neither sink nor swim in opthalmology but after listening to ur lectures i can confidently swim in opthal topics.
    thanks a million for helping students like me….

  10. Hi sir
    Iā€™m a GP from IRAN-In middleast- please send this video to my email,so i can give it to my other Friends-DOCs- in iran.
    in our country we can NOT Donlowd your VERY NICE, USEFUL & informative VIDEOS
    this is my email address HOPE to:

    drp_allameh@yahoo.com

    THANK YOU DEAR Dr ROOT
    WITH BEST WISHWES

    DR PEYVAND ALLAMEH MD

  11. Dr. Root,

    Thank you sincerely for providing these outstanding educational Ophthalmology lectures & videos. I have a renewed appreciation for the intricacies of Ophthalmology thanks to you! I also have a clearer understanding of the various pathology and treatments. And last, a huge compliment to you for ” paying it forward” and educating so many with your incredible talents for free !

    I will eventually purchase your book!
    Deborah

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