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Eye injury to order
mha_chan wrote in little_details
Hi :)

I want to give my character a penetrating injury to one eye where the six-month outcome is little vision in that eye, ideally such that the character has lost a lot of his binocular vision, but not badly enough to be enucleated. What sort of injury would cause this? symptoms, progonsis, etc?

(I've read about whatsitcalled, Sympathetic ophthalmia, that thing where the uninjured eye ends up being like eaten by the immune system so doctors take the injured eye out to prevent this, but I also read an article saying that that is rare and therefore I'm assuming it won't happen to my character :3 ).

terms I have googled: injury to eye, penetrating injury/wound/trauma to eye, corneal laceration, global rupture.

I've come across many medical articles which I have no doubt would have been very useful if I could understand them. >< I'm annoyed with myself, usually I have enough biology to skim-read medical articles but I know nothing about eyes that aren't mine. So if someone can give me a layman's explanation that would be great. From my reading a severe corneal laceration looks like the best bet, but I'm not sure.

also any ideas about what the damaged eye would look like after 6 months will be greatly appreciated too; all of the pictures I can find are pre- or at the time of treatment.

If I haven't explained things well enough (most probable) please let me know!

If you can fudge the details a bit, I'm pretty sure some form of orbital cellulitis got from the original wound could have the outcome you want.

Almost any eye injury can cause excessive scarring and/or pigmentation - especially if there is any delay in treatment resulting in infection. Or go for it hitting with force to cause bleeding - that can damage the retina and again cause long term loss of vision. I also knew a guy who got a fractured lens from a blow doing re-enactment. As he was quite young they were not happy removing it and putting in a prosthesis so he ended up with fragmented vision that he kinda got used to

This isn't a case of actual puncture and I'm describing a dog's eye, but I believe the structure is still similar enough so that this might be at least somewhat useful: my dog managed to get a bad scratch on the cornea of one eye. It took quite a while to heal, and for the rest of his life you could clearly see (especially when looking at the eye from the side) that the cornea was slightly thicker and sort of milky where the injury had been. Understandably there's no way of knowing exactly how much it affected his vision but most probably it had some effect since it was just about smack in the middle of the eye.

Although I believe David Bowie's eye injury (which certainly dramatically affected his appearance) was a matter of blunt-force trauma, might his case be useful to study?

Just about any severe injury to the eye will do it. Radiation (including heat) or chemical burns to the cornea, trauma that damages or detaches the retina.

There are treatments for corneal injury - your patient probably won't be eligible for a corneal transplant since he's got the other eye, but he might be eligible to have a plastic lens sewn in instead or for corneal abrasion, depending how badly damaged the rest of his eye is. Corneal abrasion is a slow and unpleasant process where the lesion on the corneal is slowly ground away a little at a time to get rid of the impediment to vision and many people choose not to have it.

A traumatic physical injury, like a car accident, can cause rupture of the blood vessels in the eye, and cause bleeding. The bleeding could be either behind the retina, or somewhere else in the eye. If it is behind the retina, it could distort the membranes back there, perhaps causing a detachment, or other sight-limiting damage to the eye.

You could also look into traumatic cataracts, which is when the lense is forcibly torn free. It happened to my husband when he was a kid. He can't see out of his bad eye, unless he's wearing a specialized hard contact lense.

His pupil is an irregular shape and slightly different colour because some of his iris was torn out with the lense. His pupil has limited ability to grow and shrink to adapt to different levels of light.