The traumatized eye.

Injuries to the eye, both contusional and perforating, have a considerable visual morbidity not the least of which is a cosmetically unacceptable eye. Meticulous primary surgical repair and judicious secondary reconstruction of the eye may not only preserve visual functions but substantially improve the patient's appearance. Most cosmetic problems follow perforating eye injuries and include corneal leucomata, iris and pupillary abnormalities, cataract, phthisis bulbi and enucleation. Oculo-motor abnormalities, particularly divergent squint, are common where substantial loss of vision has occurred in one or both eyes. In the series reported 215 eyes were enucleated secondary to ocular trauma over a 10 year period (2,162 injured eyes), the vast majority following perforating injury. The risk of sympathetic ophthalmia was the reason for enucleation in 50.7 per cent of cases although sympathetic ophthalmia was identified in only two instances. Cosmetic defects secondary to contusional injuries are uncommon and mostly due to iris abnormalities and cataract.