Patients with serious eye trauma can present with nearly normal visual acuity and minimal physical examination findings. Evaluating physicians, therefore, must avoid complacency and maintain a high index of suspicion when treating patients with ocular injuries.
Complications associated with corneal laceration can be devastating.
Eye penetration may go unnoticed by the patient, particularly when small metal fragments break off and penetrate the eye, when metal is struck on metal, or when high-speed machinery is the source of the foreign body. The patient may present for care later, after the development of increasing pain, deterioration in vision, or infection. The setting in which the patient may have sustained the injury must be considered. Obtain the patient's preinjury vision assessments as well as any history of previous ocular problems or ocular surgery. Document pertinent medical history, current medications, allergies, and tetanus immunization status.