Trauma (penetrating)

Penetrating trauma is full-thickness injury of the cornea or outer wall of the eye, commonly as a result of work or DIY injuries, or assaults with sharp objects. More likely in males, presentation varies and can include eye lid laceration, iris damage, vitreous haemorrhage, and retinal tear/detachment. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and managing penetrating trauma. It outlines options for non-pharmacological management and highlights the need for emergency referral following provision of first aid measures.

Login to read further information on the diagnosis and management of penetrating trauma. 

What is penetrating trauma of the eye?

Full or partial penetration of the outer coat of the eye (the clear part, the cornea or the white part, the sclera) can result from industrial, work-related or DIY injuries, or from assaults with sharp objects. Such injuries occur three times as frequently in males as in females. Because they are so close to the eyeball, the eyelids may be injured also.

How is penetrating trauma of the eye managed?

The optometrist will check the vision and examine the injured eye to discover the extent of the damage and whether there is full or partial penetration. Any foreign bodies will be noted but not removed. Evidence of damage to the internal structures of the eyeball, such as the lens of the eye, will be looked for.

The optometrist will prescribe or supply pain relief if necessary and make arrangements for the ophthalmologist to see the patient as soon as possible on the same day.

The ophthalmologist, having examined the patient, may arrange investigations such as X-rays or ultrasound and will decide on whether surgery is necessary, and if so how soon. In penetrating injury there is a very rare risk of inflammation in the other eye, a possibility that will be watched for as the patient is followed up.

Sign in to continue

Forgotten password?
Register

Want to read the rest of this page?

If you are a member, login to view this page. If you are not a member, simply register to gain free access to the rest of this content.

Last updated

Trauma (penetrating)
Version 12
Date of search 10.12.23
Date of revision 29.03.24
Date of publication 11.04.24
Date for review 09.12.25
© The College of Optometrists