Foreign matters of an eye
Foreign matters of an eye – superficially or deeply located alien objects of various departments of the additional device of an eye, eye-socket and eyeball. Foreign matters of an eye prove dacryagogue, pain, hyperaemia and hypostasis of a conjunctiva, blefarospazmy. For identification of foreign matters of various localization external examination of eyes with an eversion a century, biomicroscopy, an oftalmoskopiya, an orbit X-ray analysis, a gonioskopiya, a diafanoskopiya of an eye and its appendages, ultrasonography can be used. The help at hit of foreign matters in an eye consists in surgical processing of a wound, plentiful washing of a conjunctival cavity, the direction of the victim in an ophthalmologic hospital for extraction of the subject which got into an eye in the non-invasive or surgical way.
Foreign matters of an eye
Foreign matters of an eye are quite widespread and serious problem in ophthalmology. Foreign matters of an eye can cause toxic and mechanical injuries of an organ of vision, inflammatory reaction (blefarit, conjunctivitis, keratit, uveit), hemorrhages (), secondary complications (glaucoma, a cataract, an otsloyka of a retina, endo-and panoftalmit).
Depending on the place of introduction of alien objects distinguish foreign matters a century, conjunctivas, corneas, an eye-socket and an eyeball. Foreign matters of an eye are divided by character on magnetic (ferriferous) and not magnetic (the tree, glass, the earth, sand containing copper, aluminum and other metals etc.).
Foreign matters of a conjunctiva
Foreign matters mucous eyes are most often presented by small objects: grains of sand, particles of the earth, metal, coal, stone, hairs, eyelashes, rigid fibers of some plants etc. Depending on introduction force foreign matters of an eye can remain on a surface of a conjunctiva or get into mucous.
At violation of integrity of a conjunctiva the foreign matter of an eye causes formation of infiltrate or the granulation from lymphocytes, huge and epitelioidny cages reminding conjunctiva tuberculosis. In due time unextracted foreign matter of a conjunctiva can be encapsulated. Foreign matters mucous eyes are followed by dacryagogue, pain, a photophobia, discomfort, blefarospazmy, conjunctivitis. Expressiveness of a conjunctival injection can be various.
Diagnostics of a foreign matter is carried out during careful external examination mucous eyes with an eversion a century. The reflex blink movements and the strengthened slezootdeleniye promotes movement of freely lying foreign matters of eyes on a conjunctival cavity; most often particles and splinters is late in the groove located along edge of a century.
Superficially lying foreign matters of eyes delete from a conjunctiva with the damp wadded tampon moistened in antiseptic solution or by jet washing of a conjunctival cavity. At introduction of foreign matters of eyes in fabric in a cavity of a conjunctiva dig in 0,5% solution of a dikain, then delete a foreign subject by means of a needle, tweezers or zhelobovaty dolotets. After extraction of a foreign matter of an eye appoint instillations of solution and a mortgaging of ointment of a sulfatsetamid for eyelids within 3-4 days.
After removal of a foreign matter of a conjunctiva of the phenomenon of irritation of an eye quickly enough regress; visual function does not suffer.
Foreign matters of a cornea
The foreign matters getting into eyes can remain on a surface of a cornea or take root into it on various depth. It depends on structure and the size of particles, presence at them of sharp teeth or sides, force and the speed of hit in an eye. The bedding of a foreign matter can be superficial, median or deep. Metal particles usually occur among the alien objects which are deeply getting into a cornea.
Foreign matters of an eye quite often damage a cornea epithelium, promoting penetration of an infection and development of a keratit. In several hours in cornea fabrics around a foreign matter inflammatory infiltrate is formed, the perikornealny vascular injection develops. Deeply located alien tala of an eye can get one end into the forward camera. Not taken superficial or it is median the located foreign matters of a cornea over time osumkovyvatsya or suppurate. Complaints include pain, feelings of a foreign matter ("grain of sand", "mote") in an eye, dacryagogue, a photophobia, an involuntary smykaniye a century, deterioration in sight.
Character and depth of foreign matters of a cornea of an eye are specified by means of a diafanoskopiya, biomicroscopy. Usually at ophthalmologic survey the foreign matter of a cornea of an eye is defined in the form of the dark or gray brilliant point surrounded with a thin rim of infiltrate. For an exception of a possibility of penetration of foreign matters into the forward camera of an eye the gonioskopiya is carried out.
Removal of a foreign matter of a cornea is made after an anesthetic solution instillation: superficial particles are carefully removed a damp wadded tampon; taken root deeply into a cornea take by means of a special spear or zhelobovaty dolotets. After extraction of a splinter the sterile protective bandage is approximately applied; instillations in a conjunctival bag of antiseptic drops, a mortgaging for an eyelid of antibacterial ointments are recommended. Also performance of subconjunctival injections of antibiotics can be required.
During removal of foreign matters from a cornea of an eye there is a danger of a perforation of a cornea or pushing through of the taken subject in the forward camera therefore all manipulations have to be carried out in the conditions of medical institution by the skilled surgeon-ophthalmologist.
After extraction of superficially located foreign matters of a cornea of an eye, significant consequences, as a rule, do not arise. Deep damage of a cornea of an eye by a foreign matter can lead further to development of the wrong astigmatism, cornea pomutneniye, decrease in visual acuity.
Foreign matters of a cavity of an eye
Foreign matters of a cavity of an eye (intraocular foreign matters) meet 5-15% of cases of all injuries of eyes. At the same time a smaller part of foreign matters is late in forward department of an eye (the forward and back camera, an iris, a crystalline lens, a ciliary body); the most part gets to back department of an eye (a vitreous body, a vascular cover).
In an eye metal foreign matters (about 85%) get more often, splinters of glass, a stone, a tree get less often. Depending on size, chemical properties, microbic pollution, localization and the time spent in an eye alien tala can cause pathological changes: the recidivous iridotsiklita resistant of turbidity and a shvarta in a vitreous body, secondary glaucoma, dystrophy and an otsloyka of a retina, and eyes. Inert small particles can osumkovyvatsya, without causing irritation; the objects infected with pathogenic flora can be followed by a purulent endoftalmit; wound large splinters quite often leads to a razmozzheniye and death of an eye.
At hit of foreign matters in an eye survey reveals existence of an entrance opening in a cornea, an iris, a pupil or a skler – gaping or with close edges. At a wound gaping through it internal covers, a vitreous body, a crystalline lens can drop out. Quite often massive hemorrhage in the forward camera of an eye comes to light. At penetration of a foreign matter of an eye through a pupil the trauma of a crystalline lens and its turbidity (a secondary cataract) is quite often noted.
Diagnostics of foreign matters of an eye demands careful inspection with performance of a diafanoskopiya, oftalmoskopiya, biomicroscopy, a gonioskopiya, X-ray analysis, ultrasonography of an eye, a tomography. For detection of metal sokolok the electrolocation, magnetic test is carried out.
Intraocular foreign matters are subject to removal in the surgical way. For prevention of an iridotsiklit, a panoftalmit, an endoftalmit subconjunctival and intramuscular injections of antibiotics are appointed.
Most often foreign matters of an eye delete through a section of a limb, a cornea or skler (a forward way) by means of a special eye magnet, tweezers or the pallet. At a subject arrangement in the back camera of an eye the iridektomiya or an iridotomiya with the subsequent extraction of a splinter is made. During the swelling of a crystalline lens, development of a halkoz or a cataract ekstrakapsulyarny or intrakapsulyarny extraction of a crystalline lens together with a foreign matter is shown. At haemo - and an endoftalmita make a vitrektomiya; at extremely heavy damages carrying out an enukleation of an eye can be required.
After extraction of not magnetic or magnetic foreign matters from an eye carry out local and system treatment. At foreign matters of a cavity of an eye the forecast concerning visual function and safety of the eye always serious.
Foreign matters of an eye-socket
Introduction of foreign matters in an eye-socket happens through eyelids, a conjunctiva, at an eyeball perforation. Splinters of metal, glass, a stone, a tree which can cause an aseptic inflammation or purulent process in an orbit (eye-socket phlegmon) occur among the objects getting here.
The clinical picture is characterized by existence of an entrance wound opening, puffiness a century and conjunctivas, ekzoftalmy, oftalmoplegiy, local loss of skin sensitivity, violation of sensitivity of a cornea. At damage of walls of an eye-socket the foreign matter of an eye can get into a nasal cavity or an additional bosom. At damage by a foreign matter of a straight line the muscle of an eye arises a diplopiya. In case of wound of an optic nerve sharp decrease in visual acuity or a blindness is noted; at damage of branches of a trigeminal nerve decrease in sensitivity of an upper eyelid, spastic a lower eyelid is observed, neuroparalytic keratit.
As the main methods of identification of foreign matters of an eye-socket serve the orbit X-ray analysis, a X-ray analysis of additional bosoms of a nose, a X-ray analysis of bones of a skull. If necessary maintaining the patient with a foreign matter of an eye is carried out by the ophthalmologist together with the otolaryngologist and the neurologist.
The foreign matters of an eye located close to a surface of an entrance opening delete after primary surgical processing of a wound. In certain cases carrying out an orbitotomiya, frontotomiya, sfenoidotomiya, etmoidotomiya, gaymorotomiya can be required. Massive antibacterial therapy is surely appointed.
The forecast depends on localization, size and character of a foreign matter of an eye-socket, weight of damages. In case there is no injury of an optic nerve, the forecast concerning safety of sight favorable.
Most often foreign matters get into eyes at non-compliance with safety measures therefore the main measures of prevention consist in use of goggles during joiner's, metalwork, agricultural and other works. At hit of a foreign matter in an eye it is not necessary to try to remove it independently – it can lead to migration of splinters, damage of deep structures of an eye and heavy complications.