Trauma (penetrating)

Penetrating trauma is full-thickness injury of the cornea or outer wall of the eye, commonly as a result of work or DIY injuries, or assaults with sharp objects. More likely in males, presentation varies and can include eye lid laceration, iris damage, vitreous haemorrhage, and retinal tear/detachment. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and managing penetrating trauma. It outlines options for non-pharmacological management and highlights the need for emergency referral following provision of first aid measures.

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What is penetrating trauma of the eye?

Penetrating trauma happens when a sharp object partly or fully breaks through the outer layer of the eye, either the cornea (the clear front part of the eye) or the sclera (the white part of the eye). It can result from industrial, work-related or DIY injuries, or from assaults with sharp objects. These injuries are more common in men. Because they are so close to the eyeball, the eyelids may also be injured.

How is penetrating trauma of the eye managed?

The optometrist will check the vision and examine the injured eye to assess the extent of the damage and determine whether there is full or partial penetration. Any foreign bodies can be identified but not removed. Evidence of damage to the internal structures of the eyeball, such as the lens of the eye, will be looked for.

The optometrist will prescribe or supply pain relief if necessary and make arrangements for the ophthalmologist (specialist eye doctor) to see the patient as soon as possible on the same day.

Having examined the patient, the ophthalmologist may arrange investigations such as X-rays or ultrasound and will then decide on whether surgery is necessary, and how soon. In penetrating injury to the eye there is a very rare risk of inflammation in the other eye, a possibility that will be watched for as the patient is followed up.

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Last updated

Trauma (penetrating) - 11 April 2024
The signs section has been revised to provide greater clarity on the findings associated with penetrating injury and recognising it’s variable presentation.

Version 12
Date of search 10.12.23
Date of revision 29.03.24
Date of publication 11.04.24
Date for review 09.12.25
© The College of Optometrists