Almost anyone who suffers a blow to the face and sees constant flashes of light is smart enough to consult an eye doctor quickly. But eye trauma sometimes results in a subtle, long-term injury that slowly and painlessly threatens sight.
What Is Eye Trauma?
Most of us think of trauma as something obvious. An elbow smacks us in the head during a basketball game; we fall in the house and strike furniture as we topple; chips of wood, glass and metal fly into the eyes at high speed. That’s why we should wear protective eyewear around machinery and, if possible, protective headgear while playing sports.
Yet serious eye trauma comes from unexpected places. An exercise band or bungee cord snaps back to whack us in the face. People have been seared by sparks from fireworks while sitting hundreds of feet from the launch site.
An auto accident may cause trauma, even if you don’t immediately have grogginess or blurred vision. The brain and eye aren’t meant to accelerate and decelerate rapidly, so a crash can do hidden damage. A tiny retinal tear can let fluid under the retina over the course of weeks or even months, leading ultimately to loss of vision. Because the retina has no pain receptors, you won’t get a clue that way.
What Is Affected?
Your retina, a membrane less than half a millimeter thick, holds photoreceptor cells that send information to our optic nerves. It stretches and thins naturally as we age, especially in cases of high myopia (near-sightedness) that elongate the eye.
Meanwhile, the vitreous — a gel-like substance that fills in the back cavity of the eye — begins to separate over time from the retina. It’s more adhesive in some people, which causes a retinal tear as it recedes. Fluid can pass through that tear into the space behind the retina, causing the retina to tear further. (This is a rhegmatogenous detachment, the most common type.)
An annual eye exam with dilation can catch small retinal changes. But eye trauma may make you see a sudden increase in the size or number of floaters, the tiny specks most of us have in our eyes, or repeated bursts of light like photographic flashes alongside your head. (Our eyes process images by inverting and reversing them. Flashes on the upper right, say, indicate a tear on the lower left.) Other symptoms include blurred vision, reduced peripheral vision or a shadow over your visual field.
At that point, you should get to an eye doctor within 24 hours. Retinal detachment separates retinal cells from blood vessels that provide oxygen and nourishment; the longer that goes on, the likelier you are to have permanent vision loss.
What Are The Treatments For Eye Trauma?
A doctor can perform a laser treatment that’s like spot-welding on a torn retina, sealing the edges of the tear to keep it from growing. A retina can be reattached with surgery, including a technique called pneumatic retinopexy. There a doctor injects a gas bubble into the eye and seals the tear in the retina with a freezing probe or laser; the bubble helps to flatten the retina, so it forms a seal with the wall of the eye, and the eye slowly absorbs the bubble.
But the key to dealing with eye trauma is always to seek help immediately. The longer you wait, the less any doctor may be able to do.