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Each year more than 2.5 million eye injuries occur in the United States. Eye injuries can lead to several eye problems including glaucoma which is usually caused by a blunt force trauma to the eye. The natural drain (trabecular meshwork) of the eye sits at the base of the iris and circles around the inside of the eye for 360 degrees.
When a blunt force compresses the eye, the shearing forces can cause the trabecular meshwork to tear or bleed. Tearing and bleeding results in scarring of the trabecular meshwork, reducing its ability to drain fluid. This may lead to elevated eye pressure which can damage the nerve in the back of the eye (glaucoma).
Damage to the internal drainage system of the eye occurs in 75% of blunt eye injuries. The amount of damaged drain is predictive of the risk for glaucoma. When more than half of the drain is damaged, the risk is about 10%. This can develop many years after the initial damage. Therefore, it is crucial for someone who has sustained such an injury to have periodic eye exams for the rest of their life so that, if glaucoma develops, it can be detected and treated before significant vision loss occurs.
Unfortunately, there is no cure for traumatic glaucoma; however, there are many effective treatments. Because there is no cure, prevention and early treatment interventions are exceedingly important.
The first-line treatment for traumatic glaucoma is eye drops placed in the eye on a regular basis. In cases where the eye pressure is high and not controlled by eye drops, surgery may be required to bring the pressure down to a safe level. The goal of treatment is to lower the pressure to prevent continued vision decline, but there is currently no way to restore vision that was already lost due to pressure damage.
While glaucoma due to injury usually can be controlled, prevention is always better than treatment. The use of proper eye protection (safety glasses, goggles, face shields) can prevent over 90% of eye injuries. So, whenever possible, where potential for injury is present, protect your eyes; that simple act could save your sight.
Article by Rajesh K. Shetty, MD and Kathryn B. Freidl, MD.
Rajesh K. Shetty, MD, is a board-certified, double fellowship-trained ophthalmologist specializing in cataract and glaucoma surgeries. He is currently the CEO and Managing Partner of Florida Eye Specialists and the surgery center.
Kathryn B. Freidl, MD, is a board-certified ophthalmologist at Florida Eye Specialists, specializing in cataract and glaucoma surgery. She completed medical and surgical fellowship in glaucoma at the Wills Eye Institute in Philadelphia.
Last reviewed on January 04, 2021
This article appeared in the January 2021 issue of Gleams.Subscribe