Shallow corneal abrasion: the conjunctival sac should be bandaged with antibiotic eye ointment, not local anesthetic.

Corneal stromal edema: local use of glucocorticoid or hypertonic solution to accelerate the absorption of edema. Corneal transplantation can be considered for refractory edema of corneal stroma for more than 6 months.

Corneal rupture: carefully suture with 10-0 nylon silk thread under microscope. Patients with prolapse of eyeball contents should be treated at the same time. Pay attention to the recovery of anterior chamber after operation, and apply antibiotics and mydriatic drugs after operation. After 6 months, the corneal transplantation was decided according to the vision and the size of corneal scar.

2. Iris contusion

(1) Traumatic mydriasis: Some patients can recover spontaneously by oral or intramuscular injection of vitamin B 1, B 12 and similar drugs, but they cannot recover if the sphincter of pupil is completely ruptured. You can wear colored glasses under strong light.

(2) Iris root detachment: diplopia or large detachment should be treated as soon as possible, and the detached iris should be sutured in the corneoscleral margin.

(3) Traumatic iridocyclitis: drop glucocorticoid eye drops or non-steroidal anti-inflammatory drugs and mydriatic agents.

(4) Traumatic aniridia: Those with severe photophobia can wear small-hole colored glasses or install artificial iris.

3. Ciliary contusion

Mild contusion: glucocorticoid eye drops can be used and indomethacin (indomethacin) can be taken orally.

Ciliary detachment: 1) Simple ciliary detachment If the intraocular pressure is greater than 8mmHg or the detachment range is less than 2 clock directions, the anterior chamber is not shallow and the vision is good, you can observe 1~2 months, and give 1% atropine eye drops for short-term treatment of mydriasis. 2) For those with large detachment range, ciliary body reduction under direct vision should be performed in time. Cutting and sewing are often used. On the basis of determining the position of the disconnected clock, the operation should be extended to both sides 1 time limit. Before operation, 1% pilocarpine eye drops were given to prevent the accumulation of iris root tissue in the corner of the room.

4. Anterior chamber hemorrhage

First aid: Binocular bandage, semi-recumbent position. Use hemostatic drugs, such as phenylethylamine (hemostatic sensitivity), carbachol (Anluoxue) and batroxobin (reptilase). Can't take non-steroidal anti-inflammatory drugs such as aspirin. Under normal circumstances, the pupil does not dilate or contract. If necessary, compound tropicamide was used to dilate pupils, and glucocorticoid eye drops were used in iridocyclitis. Patients with recurrent bleeding were given Yunnan Baiyao, 0.5g, 3 times a day. Those with excessive hyphema (more than 50%), blood clots, non-absorption for more than 7 days, or high intraocular pressure that has not improved after treatment with acetaminophen and mannitol (intraocular pressure < 60 mmhg for 48 hours; If the intraocular pressure is less than 25mmHg and the duration of complete hyphema is less than 5 days, the anterior chamber should be punctured and washed, or the anterior chamber should be washed with 1:5000 urokinase saline to dissolve and suck out the blood clot.

5. Corneal blood staining: those who have corneal blood staining or have a tendency to corneal blood staining should do anterior chamber puncture and washing in time.

6. Anterior chamber angle retreat

For secondary glaucoma, drugs such as prostaglandin derivatives, beta blockers and carbonic anhydrase inhibitors can be used to reduce intraocular pressure, but mydriatic agents are ineffective or cause intraocular pressure to increase. Filtration surgery is more effective.

7. Traumatic hypotony

Mild patients can gradually recover, and 1% atropine can be used to mydriasis, and glucocorticoid can be applied locally or systemically. When drug therapy fails, surgical treatment can be considered, including ciliary photocoagulation or thermal coagulation, suture and scleral buckling.

8. lens contusion

Contusion cataract: iris sealing ring does not need treatment. Local lens opacity can be observed temporarily, and cataract extraction and intraocular lens implantation are feasible for patients with progressive opacity. Patients with lens cortex protruding into anterior chamber and contacting corneal endothelium or secondary glaucoma should undergo emergency surgery.

9. The lens is detached from the anterior chamber: mydriasis, the patient lies on his back, and the position of the head is changed to make the lens enter the posterior chamber. After entering the posterior chamber, 0.5%~ 1% pilocarpine was dripped into the eye, and the pupil was narrowed 4 times /d, then peripheral iridectomy was performed. Lens extraction after failure

10. lens detachment into vitreous body: the lens capsule is intact, and the patient has no symptoms and inflammation, so observe; If the lens capsule breaks and inflammation occurs, a flat incision vitrectomy will be performed.

1 1. lens subluxation: asymptomatic, continue to observe; High astigmatism or monocular diplopia: Patients with unsatisfactory vision correction or progressive increase of ametropia or secondary glaucoma need surgical treatment, including lens extraction and intraocular lens implantation.

12. Vitreous hemorrhage: properly handle eye trauma and rest in bed to rest the eyeball. For those with fresh hematocele, hemostasis is the main method. Drugs to promote blood absorption should be used after bleeding stops, and vitrectomy should be performed before vitrectomy for patients with large bleeding or bleeding that has not been absorbed. The timing of operation is generally between 2 weeks and 2 months after injury. Vitrectomy should be performed as soon as possible when retinal detachment is found by B-ultrasound.

13. Choroidal contusion

A small amount of bleeding: rest and give drugs to stop bleeding or promote blood absorption. When blood enters the vitreous body, it is regarded as vitreous blood. When choroidal detachment is ineffective after drug treatment, bleeding or effusion can be discharged through scleral incision at the bleeding site, and then electrocoagulation or condensation can be performed.

Within 72 hours after FFA examination found CNV, if CNV was far away from macular fovea and the distance was more than 200um, laser treatment was performed; CNV under macular fovea can be treated by intravitreal injection of anti-VEGF drugs, photodynamic therapy and surgery.

14. Retinal concussion: vasodilators, vitamin B 1 and oral glucocorticoids were used.

15. Retinal hemorrhage: rest with head high, and take hemostatic drugs and vitamin C orally.

16. Macular hole: generally no treatment is needed. If the hole edge is pulled, the hole can be closed by surgery.

17. traumatic retinal detachment: after finding the hole, it should be closed in time. If traction retinal detachment is caused by vitreous hemorrhage, vitrectomy combined with retinal reattachment is sometimes needed.

18. optic nerve contusion: early retrobulbar injection of tolazolin and dexamethasone, systemic application of glucocorticoid and mannitol to alleviate edema around optic nerve. Vitamin B 12, ATP and vasodilator were given at early stage. If there is an optic canal fracture, contact otolaryngology and neurosurgery for surgical treatment.

19. Eyeball rupture: If the injured eye is found to be torn, the wound should be sutured as much as possible first, and vitrectomy should be considered in about 2 weeks. Some patients can keep their eyeballs and may have some useful eyesight. The eyeball structure has been completely destroyed. Consider gouging out or gouging out. [ 1][2][3]