Ocular trauma can result in mild and temporary visual impairment or severe and permanent loss of vision.
Some medical-legal issues in cases of ocular trauma include:
- Type of injury. Chemical injuries from acids tend to be less injurious than from substances with a high base level.
- Level of penetration. Injuries that penetrate beyond the first layer of corneal tissue tend to produce scar tissue.
- Location. Scar tissue in the central portion of the cornea is much more likely to lead to visual impairment than scar tissue located in the peripheral cornea.
- Injuries that produce inflammation in the eye can cause scar tissue, glaucoma, and cataracts.
- Penetrating eye injury cause significant internal damage to the eye. Some of the complications of penetrating eye injuries can be corneal scar formation, cataract, glaucoma, hyphema (blood in the front of the eye), vitreous hemorrhage (blood in the back of the eye), retinal tears, retinal detachment, and optic nerve damage.
- Sympathetic ophthalmia is a rare condition from penetrating eye injury that results in inflammation (uveitis) in both eyes with possible loss of vision. Michael Reynard, M.D. has published numerous articles about eye injuries and the development of sympathetic ophthalmia.
Treatment of Eye Injuries
- Prompt attention and thorough evaluation is often needed to assess damage and immediacy of treatment. Intraocular foreign bodies usually require prompt removal to avoid endophthalmitis, a potentially serious and vision threatening complication.
- Proper selections of medications are needed to efficiently treat and manage specific injuries.
Cases in Point
Dr. Reynard was retained to evaluate damages for a child who developed a severe eye infection following eye trauma and an undiagnosed intraocular metallic foreign body. The patient’s ocular foreign body resulted in severe infection and loss of vision.
Dr. Reynard was asked to perform an IME to assess causation and damage in a visually impaired individual who sustained chemical injury to the eye from a disinfecting skin cleaner.
Dr. Reynard was retained by an insurance company to evaluate neuro-ophthalmic impairment in a patient with gunshot injury to the eye and brain.
Dr. Reynard has published articles on sympathetic ophthalmia and ocular trauma in the American Journal of Ophthalmology, Archives of Ophthalmology, and British Journal of Ophthalmology.