Ocular penetrating and perforating injuries can result in severe vision loss or loss of the eye. Penetrating or perforating ocular injuries can be due to injury from any sharp or high velocity object. The home is the most frequent location for injuries. The most common blunt objects reported by the United States Eye Injury Registry were rocks, fists, baseballs, lumber and fishing weights. The most common sharp objects were sticks, knives, scissors, screwdrivers and nails.
Ophthalmic examination after severe trauma can be difficult. Obtaining a visual acuity and pupillary examination may be the most important elements to ascertain. Obvious trauma requires careful handling of the eye with care taken to prevent any pressure on the globe if an open globe is suspected.
When direct visualization is not possible, gentle ultrasound and computed tomography should be used to evaluate the globe. Magnetic resonance imaging is contraindicated in any case where a metal object is thought to be involved. Often surgical intervention may be required.