About Eye Injury关于眼外伤

What is eye injury?

什么是眼外伤？

Eye injury refers to the eye structural and functional impairment caused by external force or chemical exposures or burns. It is one of the major causes for blindness. The common causes of eye injury include falling, fighting, sports or accidents. 

眼外伤是由与外力或化学性等因素直接作用于眼部，引起眼的结构和功能损害, 是造成盲目的主要原因之一。通常跌倒、打架、运动或意外是眼外伤主要原因。

 

About Children's Eye Injury
关于儿童眼外伤

Active children are the group especially needs to be educated and monitored for eye injury. The interesting toys such as wood sticks, stones, slingshots, toy gun bullets etc. can be dangerous. School children are also need to be careful not to play with sharp pencils. It is tradition to set off firecrackers on Spring Festival, the Chinese New Year and it happens that children could get eyes hurt in such activity. Ill management of inflammable and explosive articles can also be the cause of children eye injury. In recent years, playing with the disposable syringe among school children which resulted in eye penetrating injuries and caused serious consequences such as suppurative endophthalmitis was clinically observed. 

儿童活泼好动,日常生活中尤其应该预防眼外伤。儿童在打闹玩耍中容易用木棍、石块、弹弓、气枪子弹、玩具等损伤眼睛；小学生在用小刀削铅笔时也有不慎扎伤眼睛的；我国春节燃放鞭炮是传统活动，儿童参与不慎引发眼上海也常常发生。如果雷管等易燃易爆物品管理不善，被儿童当作玩具玩耍或燃放，很容易引起眼爆炸伤。近年来，儿童玩耍一次性注射器，刺伤眼球的情况也较为多见，往往形成化脓性眼内炎，后果严重。

 

 

Types of Eye Injury
眼外伤类别

According to the seriousness, eye injuries can be classified into three levels, mild, moderate and serious.

眼外伤分类按眼外伤的轻重可分为轻、中、重三类。

 

Mild eye injury includes eye lid bruise and blood stasis, subconjunctival hemorrhage, foreign body on cornea and conjunctiva surface, corneal epithelium scratch, first-degree eyelid thermal burn, irritant gas injury, electro-optic ophthalmitis etc..

轻度眼外伤包括眼睑擦伤及瘀血，结膜下出血，结膜及角膜表面异物，角膜上皮擦伤，眼睑Ⅰ度热烧伤，刺激性毒气伤，电光性眼炎等。

 

Moderate eye injury means eyelids (tear duct) laceration, 2nd-degree eyelid thermal burns, bulbar conjunctival laceration, superficial corneal foreign body etc..

中度眼外伤包括眼睑(及泪小管)撕裂伤，眼睑Ⅱ度烧伤，球结膜撕裂，角膜浅层异物等。

Severe ocular injury includes extensive avulsion or defect of eyelid, 3rd-degree eyelid thermal burns, eyeball perforation, intraocular foreign body, blunt eye injury (with internal bleeding), 2nd-degree and above eyeball thermal burns or chemical burns, radiation injury and serious military gas injury, orbital fracture etc..

重度眼外伤包括眼睑广泛撕脱或缺损，眼睑Ⅲ度烧伤，眼球穿孔伤，球内异物，眼球钝挫伤(伴眼内出血)，眼球Ⅱ度以上热烧伤或化学烧伤，辐射伤和严重的军事毒气伤，眼眶骨折等。

First Aid of Eye Injury

眼外伤急救

1. Eyeball perforation is usually caused by sharp objects such as knife, scissors, needles or high-speed flying objects hit and penetrate the eyeball wall. Patient would feel severe pain, hard to open the eye, quick vision decline. Some patient would feel “warm tear” running down. Eyeball perforation is one of the most serious eye trauma. Bacteria may affect the eye through wound and cause eye inflammation, pyosis. Eyeball may collapse and atrophy due to the vitreous body leakage. Vision impairment or blindness can be caused due to the internal tissue damage. 

穿通伤：最常见的眼球穿通伤是由于刀、剪、针、高速飞来的异物刺穿或击穿眼球壁所致，患者可感觉到眼睛疼痛、眼睛睁不开、视力急剧下降，有的患者会有“热乎乎”的眼泪流出来。眼球穿通伤是最严重的眼外伤之一。细菌可经创口进入眼内而导致眼球发炎、化脓，也可因眼睛内容物流出致眼球塌陷、萎缩。由于眼内组织受伤，可造成严重的视力损害，甚至失明。

First Aid Principle

急救策略：

1.Gently cover the wound eye with gauze. If gauze not available, try loosely taping a paper cup on the wound eye for protection. Do not try to remove any tissue or foreign body on or in the eye. Do not press the eye to avoid intraocular tissue or contents leak out can cause worse damage. 

用纱布轻轻包盖伤眼，不要尝试去除粘在眼睛或眼皮内的任何组织，千万不要揉压眼球，以免眼内组织及眼内容物自伤口处脱出于眼外，造成更大的伤害。

 

2.Visit eye hospital immediately for medical help.
立即去条件比较好的医院急救。

 

3.Beware the sympathetic opthalmia! An injured eye can cause inflammation of normal eyes so the top priority of trauma aid is to be quick in getting medical treatment. 警惕交感性眼炎。有时候，受伤眼会引起对侧正常眼睛发炎，若不及时抢救，可造成双目失明，需引起重视。

 

Blunt eye injury: when eyeball being hit by a blunt tool or a stone, subconjunctiva hemorrhage can be caused in less serious case while permanent vision damage by intraocular bleeding, iris, lens, optical nerves, cornea damage or eyeball rupture can be cause in serious case.

钝挫伤：当眼球被钝器、石头等击伤后，轻者可造成眼睛表面出血(结膜下出血)，重者可造成眼球内出血，虹膜、晶状体、视神经、视网膜损伤，甚至眼球破裂，导致永久性视力损害。

 

First Aid Principle

急救策略：

 

1.Visit eye hospital immediate after being hit. Though the subconjunctiva bleeding can be absorbed in 1 – 2 weeks and would not pose permanent loss to vision, intraocular bleeding belongs to more serious condition and could lead to permanent vision impair if not treated in time. 
眼球被击伤后，无论伤势轻重，均应立即去医院就诊。通常，眼睛表面出血1～2周后会自行吸收，不影响视力。眼球内出血比较严重，若不及时治疗，可导致永久性视力损害。

 

 

2.Eyelid swelling and subcutaneous bleeding may appear after being hit. Do not massage or use hot compress which may induce more subcutaneous haematomas. Ice bad or cold water can be used for local compress to reduce swelling and pain. Hot compress can be used in 24 hours when bleeding stops. 
眼睑被击伤后，可引起眼睑肿胀、皮下出血等症状。切忌按揉和热敷，以免加重皮下血肿。而应立即用冰袋或凉水进行局部冷敷，以期消肿止痛。24小时后出血停止，可改为热敷，促进局部瘀血的吸收。

 

Chemical Burns: chemical substances get into eye can cause serious intraocular damage. 

化学烧伤：当硫酸、烧碱、氨水、石灰等具有强烈腐蚀性的化学物品不慎溅入眼内时，易对眼内组织造成严重损伤。

 

First Aid Principle

急救策略：

 

1.Rinse the wound eye immediately with water. Do not delay by searching for clean water. Rinse with running water for long enough, better not less than 30 minutes. 
立即用清水冲洗受伤的眼睛，越快越好，对于水质不必过分苛求，有什么水就用什么水，绝不能因为寻找干净水而耽误时间。用水量要足够多，冲洗时间要足够长，最好达到30分钟。

 

2.When rinsing, use thumb and forefinger to open the eyelid for the wound eye so the chemical substance all can be washed out.
冲洗时，伤眼在下方，用食指和拇指扒开眼皮，尽可能将眼内的腐蚀性化学物品全部冲出。

 

3.If running water is unavailable, immerge the wound eye into a basin of water and repeat open-then-close-eyelid movement. Use thumb and forefinger to help open then close eyelid, meanwhile move eyeball so the intraocular chemical substance is fully in contact with adequate water. Change water if circumstance allows. 
如果没有流动的水，可以让伤员立即将伤眼浸入一盆水中，边做睁眼、闭眼运动，边用手指不断开合上下眼皮，同时转动眼球，使眼内的化学物质充分与水接触。救助者可再打来一盆水，以便更换。

 

4.Do not rinse the eye when calcined lime gets into eye because when in contact with water, calcined lime would changed into alkaline slaked lime during the process a great amount heat is produced. The right way is to clean the calcined lime with cotton sticks or handkerchief then flush. 
生石灰溅入眼内后，不能用手揉，也不能直接用水冲洗。因为生石灰遇水会生成碱性的熟石灰，同时产生大量热量，反而会加重对眼睛的损伤。正确的方法是，用棉签或干净的手帕一角将生石灰粉拨出，然后再用清水反复冲洗伤眼。

 

5.After 30 minutes flush, visit eye hospital as soon as possible. 

伤眼冲洗完毕后，应立即去医院接受进一步检查和处理，包括进一步彻底冲洗、使用酸碱中和药物等。
 

Foreign Body Injury: when foreign body gets into eye, patient would have sensation, afraid of light, tearing and hard to open the eye. Patient’s involuntarily action of rubbing the eye with hand or handkerchief may lead to foreign body being embedded deeper into eye tissue and hard to be taken out. 

异物伤：当异物飞入、溅入眼内时，患者可有异物感、怕光、流泪、无法睁睛等不适。这时候，人往往会不由自主地用手或手绢揉擦眼睛。殊不知，这么做不仅无法解决问题，反而会使异物嵌入组织内难以取出。

 

First Aid Principle

急救策略：

 

1. If dust gets into eye, have a helper pull eyelid outward and blow gently into the eye to irritate the eye into tearing so dust can be washed out.

救助者用两个手指头捏住上眼皮，轻轻向前提起，向眼内轻吹，刺激眼睛流泪，以便将沙尘等带出。

 

2.If method above does not work, please visit eye doctor immediately. Doctor will turn out the eyelid and inspect the surface with the help of surface anesthesia.
上述方法若不奏效，应立即去医院诊治。医生会在表面麻醉后，翻开眼皮，直接查找异物。找到异物后，用无菌棉签将异物轻轻沾出，或用生理盐水、抗生素眼药水冲出，随后用抗生素眼水滴眼，防治感染。

 

3.Do not rub the eye or try to remove the foreign body by yourself, especially the foreign body located on cornea. The cornea being affected, white scar can be cause along with the possibility of serious consequences such as corneal perforation, intraocular inflammation, eyeball atrophy etc., in either case vision loss is definite. 
千万不要用手揉眼睛或自行取异物，尤其是位于角膜(黑眼珠)上的异物，以免导致意外或感染。角膜一旦发生感染，不仅可能遗留明显的白色瘢痕，还可能发生穿孔、眼内炎、眼球萎缩等严重后果，最终造成视力丧失。

 

4.Metal piece flying into eye may cause eyeball wall perforation, intraocular hemorrhage, secondary glaucoma, retinal detachment, endophthalmitis etc. Patient needs to visit eye hospital with the metal piece source as soon as possible. Doctor can decide the treatment plan according to whether the metal is magnetic. 
金属屑飞溅入眼内时，可能会导致眼球壁穿孔、眼内出血、外伤性白内障、继发性青光眼、视网膜脱离、眼内炎等，患者应携带碎屑来源金属，尽快去医院就诊，由医生根据金属是否有磁性，决定下一步诊治方案。