The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Blunt trauma to the eye or periorbital tissues is usually accidental, as a result of workplace, domestic and sports-related injuries, falls or road traffic accidents. It occurs most frequently in young males. Falls account for 25% of cases in people aged 70 and over. Symptoms can include pain, watering, visual disturbance or blurred vision, light sensitivity, double vision and floaters and flashes. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating blunt trauma. It outlines options for non-pharmacological management and pharmacological treatment, and highlights the potential need for emergency referral to A&E for severe cases.
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What is blunt trauma of the eye?
The eye is well protected by the bony structures of the face that surround it (brow, cheek, nose). Blunt trauma is an injury to the eye or surrounding structures from a forceful impact, for example, a fall, or sometimes the result of an assault.
How is blunt trauma of the eye managed?
In mild cases this often results in bruising and swelling of the tissues around the eye (a ‘black eye’) that resolves fully in time leaving no after-effects. Painkillers may be the only treatment needed. In more severe cases one or more of the bones of the orbit (the bony cavity in which the eyeball sits) may be fractured and this may cause the eye or one of the muscles that moves it to be displaced. The blow to the eye may also damage the structures inside the eye and may cause internal bleeding or raised eye pressure. Such cases need to be referred as emergencies to the ophthalmologist (specialist eye doctor).
Trauma (blunt) - 13 March 2026 The predisposing factors section has been amended to include additional factors that increase the risk of blunt trauma to the eye and/or extraocular tissues. The symptoms section has been amended to better describe the typical symptoms of blunt trauma that may be reported at presentation. The signs section has been reorganised to clearly set out the typical ocular features observed in severe cases including those for orbital ("blow out") fracture. The non-pharmacological management section has been amended to explain the importance of excluding open globe injury and to avoid exerting pressure on the eye where this is identified.
Trauma (blunt) - 11 April 2024 The signs section has been revised to provide greater clarity on the typical findings in mild cases of blunt trauma and recognises the variable presentation in severe cases. Additional pharmacological recommendations have been provided to help manage symptoms and signs observed in mild cases.
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