Ophthalmologic emergencies and prevention of eye injuries in traffic accidents

During the acute episode of any conjunctivitis it is recommended not to drive

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Acute conjunctivitis

The basic symptom is a foreign body sensation, accompanied by burning, itching, photophobia, blepharospasm and lacrimation. In allergic conjunctivitis, the patient develops significant eyelid edema and conjunctival swelling.

With eyelid edema, motility and visual field are reduced.

Tips

  • Remove lenses, apply therapeutic eye drops and protect with dark glasses.
  • During the acute episode of any conjunctivitis it is recommended not to drive, particularly if lenses are used and no replacement prescription glasses for darkness are available.

Vernal keratoconjunctivitis

A condition generally allergic in origin and recurrent which causes intense itching, lacrimation, photophobia and mucous discharge.

In some cases, a small loss of corneal epithelium occurs, causing pain and increased photophobia.

Herpes simplex keratoconjunctivitis is a recurrent condition that can cause ulcers in the cornea and residual fibrosis.

Tips

  • The patient should not drive until the treatment obtains the absence of symptoms, and if a residual injury can occur, an ophthalmologic study and report from the specialist indicating driving limitations are required.

Blepharitis, hordeolum and chalazion

Inflammation of the lid margin with redness and edema usually causes a foreign body sensation, itching, burning, lacrimation and photophobia.

Tips

  • They can interfere with driving by causing a great discomfort and decreasing visual field. It is advised against driving until symptoms are absent.

Uveitis

It presents with decreased or hazy vision, floaters and symptoms related to its complications, such as increased ocular pressure, retinal detachment or cataract.

It is an important injury and an associated systemic disease is present in 40% of cases.

Tips

  • The patient must not drive until he obtains a favorable report from the specialist with the cure of the condition without sequels.

Foreign bodies

In the conjunctiva, their entry is usually accompanied by their immediate exit by the action of blinking, causing only transient irritation. The rubbing of the foreign body on the corneal epithelium may erode it.

In the cornea, foreign bodies become lodged in the epithelium. A drop of anesthetic must be applied to the eye for their treatment, and followed by their removal, an erosion will always remain on the cornea.

Corneal erosions

They cause severe pain and intense associated blepharospasm.

They are medical emergencies that should be treated by a specialist and may leave important sequelae when they cure with replacement by fibrous tissue.

They usually cure in 24 or 48 hours with antibiotic ointments, short-acting cycloplegics such as homatropine, and keeping the eye firmly covered to prevent blinking.

Advice on foreign bodies and corneal erosions

  • With the presence of a foreign body in the eye, the patient cannot drive.
  • The patient should not go driving to the emergency room for removal of it.
  • If the foreign body enters the eye while driving for the window being down, stop immediately the car, with care for traffic safety and ask for help.
  • Washing the eye is a good measure, but if the symptoms persist, leave the car parked and that the emergency services take care or move you to the appropriate health center.
  • The specialist physician’s report will specify the changes that may have occurred in the visual capacity and their influence in driving.

Sudden vision loss

It is an alarming situation. The diseases of the posterior pole of the eyeball that cause they symptoms are painless.

The most frequent causes are:

  • Vascular due to ischemia or retinal or vitreous hemorrhage related to atherosclerosis, arterial hypertension, heart disease and diabetes.
  • Inflammatory due to papillitis and chorioretinitis.
  • Retinal detachment, most frequently in patients operated on for cataracts and/or with myopia.

Tips

  • Even in the case of amaurosis fugax or affecting only one eye, the patient cannot drive.
  • The patient cannot drive until the causal diagnosis is confirmed, treatment applied and vision recovered or adapted.
  • In the case of irreversible injuries reducing visual capacity, a medical report should be provided that allows for assessing the skill for driving during the evolution of the disease.

Eye trauma

Even if they are not serious, they cause great anxiety in the patient due to the pain and their effect on vision.

The causes may be thermal, chemical, exposure to intense light, contusions from foreign bodies, or wounds.

Tips

  • In any case, the patient cannot drive until complete cure or assessment by the specialist of the injuries and their interference with driving, that will be supported in the appropriate report.

Advice on prevention of eye injuries in traffic accidents

  • It is advisable to always use protective measures such as the safety belt, headrest and helmet.
  • The airbag should be at a distance from the body greater than 25 cm, and the safety belt should be fastened, as the speed with which the body is launched forward in the impact is greater than that of airbag inflation. The function of the safety belt is to hold the body during that time.
  • Objects between the body and the steering wheel should be avoided, and it is better to drive with glasses, if possible.
  • Other safety measures are laminated glasses, a resistant car space with deformable, soft materials, and try that there are no overhangs in the car.