Mechaniczne uszkodzenie oka. Jak zdiagnozować uraz i jakie badania należy przeprowadzić?
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Mechaniczne uszkodzenie oka. Jak zdiagnozować uraz i jakie badania należy przeprowadzić?

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Urazy oka to uszkodzenia tkanek oka, do których dochodzi w wyniku działania czynników zewnętrznych, m.in. mechanicznych, chemicznych, termicznych czy promieniowania elektromagnetycznego. Jakie objawy wskazują na uraz mechaniczny oka oraz jak go leczyć?

Uraz mechaniczny może wywołać uszkodzenia zamknięte bądź otwarte. Do zamkniętych zalicza się stłuczenia, rany warstwowe oraz powierzchowne ubytki nabłonka rogówki (erozje). Urazy otwarte natomiast to pęknięcie gałki, rany penetrujące gałkę oczną (gdzie rana wlotowa i wylotowa znajdują się w tym samym miejscu), rany perforujące gałkę oczną (gdzie rana wlotowa i wylotowa znajduje się w różnych miejscach), a także ciała obce wewnątrzgałkowe.

Wśród najczęstszych urazów oka wymienia się tzw. drobne uszkodzenia, takie jak ciało obce pod powieką czy w rogówce bądź erozje nabłonka rogówki. A do najrzadszych, jednak najpoważniejszych urazów, które mogą prowadzić do utraty wzroku, zaliczają się zranienia penetrujące gałkę oczną, pęknięcia gałki ocznej, ciała obce wewnątrzgałkowe oraz oparzenia chemiczne.

Jak zdiagnozować uraz mechaniczny oka?

Na wystąpienie objawów wpływ będzie miał zarówno rodzaj, jak również ciężkość urazu. Co istotne, ból towarzyszący urazowi nie jest proporcjonalny do ciężkości urazu. Oznacza to, iż w przypadku lekkich uszkodzeń oka ból jest zazwyczaj zdecydowanie silniejszy niż przy urazach, których konsekwencją jest całkowita utrata wzroku. Odpowiednie postępowanie w przypadku urazu oka zapewnia szansę na zarówno uratowanie oka, jak również wzroku.

Ciężkim urazom oka towarzyszą krwotoki podspojówkowe bądź do komory przedniej i ciała szklistego, jak również wypadnięcie tkanek na zewnątrz gałki ocznej. Na uraz otwarty wskazywać będzie niskie ciśnienie wewnątrzgałkowe, które po zasklepieniu rany może wzrosnąć i wywołać jaskrę wtórną. Poważne urazy gałki ocznej mogą prowadzić również do zmętnienia i zniekształcenia rogówki, zaćmy urazowej, odwarstwienia siatkówki, a nawet witreoretinopatii proliferacyjnej.

Jakie badania należy wykonać u pacjenta z urazem oka?

W przypadku urazu oka lekarz najpierw przeprowadza wywiad z pacjentem, dokonuje oględzin oka, bada je w za pomocą lampy szczelinowej, ocenia ostrość wzroku oraz ciśnienie wewnątrzgałkowe.

Ubytek przy powierzchownych urazach rogówki ocenia się za pomocą barwienia fluorosceiną, w świetle niebieskim. Niezwykle istotne jest również zbadanie wewnętrznej strony powieki górnej i dolnej, ponieważ może się tam znajdować ciało obce, wymagające usunięcia.

Poważniejsze urazy oka wiążą się natomiast z koniecznością wykonania badań dodatkowych, takich jak USG, RTG czy TK.

Źródło: mp.pl

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