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What characterizes an Eye Concussion? How to Diagnose/Treat

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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.


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replied September 6th, 2006
Vision & Eye Disorders Answer A1457
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 manifested 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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