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Penetrating eye injury requires immediate referral because of the risk of devasting ocular infection.

Presentation:

• Most commonly seen in children at play with sharp object
• Shattered windscreen in road traffic accidents
• High velocity missles at work place

• Visual acuity is reduced due to cornea distortion or blood
• Most injuries involves the cornea or at the corneoscleral junctions. Therefore displacement 

of the iris or pupil should alert the possibility of open eye injury.

• Refer the patient immediately to the eye casualty

Figure 1. This patient sustained a left peforating eye injury when his friend threw him a  sharp pencil at school. The visual acuity was hand movement. Note the  displacement of the iris and pupil towards 8 O'clock where the perforation  occurs at the corneoslceral junction. He was admitted for wound repair and  was given antibiotic cover. The eventual visual acuity was 6/12 with glasses.

Figure 2. Another patient with a penetrating injury.  Note the iris prolapse and the "tear drop" shape iris. It is  important to exclude the presence of intraocular foreign body.

Figure 3. This man sustained a right corneal laceration in a road traffic  accident from a broken windscreen. The picture shows the  cornea immediately following primary repair. See trauma for  the management of eye trauma.

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