The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Blunt trauma to the eye or periorbital tissues is usually accidental, as a result of workplace, domestic and sports-related injuries, falls or road traffic accidents. It occurs most frequently in young males. Falls account for 25% of cases in people aged 60 and over. Symptoms can include pain, epiphora, visual loss, photophobia and diplopia. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating blunt trauma. It outlines options for non-pharmacological management and pharmacological treatment, and highlights the potential need for emergency referral to A&E for severe cases.
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What is blunt trauma of the eye?
The eye is well protected by the bony structures of the face that surround it (brow, cheek, nose) but it is sometimes injured by a direct blow, which is usually accidental but is sometimes the result of an assault.
How is blunt trauma of the eye managed?
In mild cases this often results in bruising and swelling of the tissues around the eye (a ‘black eye’) which resolves fully in time leaving no after-effects; painkillers may be the only treatment needed. In more severe cases one or more of the bones of the orbit (the bony cavity in which the eyeball sits) may be fractured and this may cause the eye or one of the muscles that moves it to be displaced. The blow to the eye may also damage the structures inside the eye and may cause internal bleeding or raised eye pressure. Such cases need to be referred as emergencies to the ophthalmologist.