What characterizes an Eye Concussion? How to Diagnose/Treat Posted: 09-02-06 16:06pm
Twice, in the past to weeks, I have seen
eye injuries in an elementary school
setting. In both cases, involving
different students, after being struck
direclty in one eye, the pupil was small,
1 to 2 mm, round and did not react to
light. The pupil of the uninjured eye was
3 to 5 mm, round and reacted normally to
light. One student was hit with a light
weight, hollow, plastic whiffle ball. The
other student was "punched" by another
student of substantial size. There were
no other signs of trauma. The injuries
were treated as emergencies and paramedics
were contacted. Both students were
transported via amublance to a hospital
emergency room. After about 2 hours, eye
function returned to normal in both cases.
I have been unable to locate possible
explanations for this reaction to an eye
injury. What is the pathology behind this
response to injury? Is there any way to
know if normal eye function will return
without intervention? I appreciate any
information or explanation you can offer.
Thank you. Note: the ht. wt. age
provided were required fields and do not
apply to this question.
According to your description of the
injuries and accompanying symptoms
(temporary loss of pupil reflex and uneven
pupil opening between both eyes after
injury), it seems to me that the students
experienced a concussion of the eye
(comotio bulbi oculi). Eye concussions are
a temporary functional disorder of the
eye. During concussions (comotio), there
are no organic damages present, but only
temporary functional disturbances. There
is no way to predict if the injury caused
any structural damage or only mainfested
as a functional disturbance without a
detailed examination (ophthalmoscopy).
Fully spontaneous recovery after some
period of time is usually a sign that
there wasn’t organic damage but only a
temporary functional disturbance
(concussion). Detailed eye examinations by
a specialist (ophthalmologist) is
necessary no matter the symptoms' severity
and duration.
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