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What examinations are needed for eye trauma?

Nov 19, 2025 Source: Cainiu Health
Dr. Wang Lei
Introduction
In general, eye injuries require targeted examinations to determine the location and extent of damage. Commonly used tests include visual acuity and visual field testing, slit-lamp examination of the anterior segment, fundus examination, imaging studies, and intraocular pressure measurement. In emergencies such as globe rupture or severe bleeding, immediate first-aid treatment is necessary. After evaluation, patients should follow medical advice to protect the injured eye and avoid rubbing or bumping it.

In general, eye injuries require targeted examinations to determine the location and extent of damage. Commonly used tests include visual acuity and visual field testing, slit-lamp examination of the anterior segment, fundoscopic examination, imaging studies, and intraocular pressure measurement. Specific details are as follows:

1. Visual Acuity and Visual Field Testing: This is a fundamental assessment for ocular trauma. Standard eye charts are used to evaluate near and distant vision, while perimetry helps detect visual field defects. Even if there are no obvious external abnormalities after injury, sudden vision loss or reduced visual field can indicate optic nerve or retinal damage, allowing for timely diagnosis.

2. Slit-Lamp Examination of the Anterior Segment: A slit-lamp microscope is used to closely examine structures of the anterior segment, including the eyelids, conjunctiva, cornea, and iris. This method clearly identifies corneal foreign bodies, conjunctival lacerations, and iris hemorrhage. It also helps assess lens dislocation and presence of hyphema (blood in the anterior chamber), providing critical information for diagnosing superficial injuries.

3. Fundoscopic Examination: Using direct or indirect ophthalmoscopy, this test evaluates the retina and posterior segment, focusing on detecting deep-seated issues such as retinal tears, detachment, macular injury, and vitreous hemorrhage. For patients with blunt trauma or penetrating eye injuries, this examination can uncover hidden damage early, preventing delayed treatment that may lead to permanent vision loss.

4. Imaging Studies: Depending on the type of injury, CT or MRI scans are selected. CT excels in diagnosing orbital fractures, intraocular foreign bodies, and extraocular muscle injuries, clearly showing bony structures and the location of high-density foreign objects. MRI offers superior soft tissue resolution and is more suitable for evaluating optic nerve contusion or intraocular tumors.

5. Intraocular Pressure Measurement: Tonometry is used to measure intraocular pressure. Eye trauma may damage the anterior chamber angle or obstruct aqueous humor outflow, leading to elevated intraocular pressure and potentially triggering glaucoma. Timely pressure monitoring allows early detection and intervention, minimizing optic nerve damage caused by high pressure.

If emergencies such as globe rupture or severe hemorrhage occur, immediate first-aid treatment is required. After examination, follow medical advice to protect the eye—avoid rubbing or bumping it—and attend regular follow-up appointments to ensure proper healing and management of the injury.

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