Eye Injuries from Head Trauma

Save vision after traumatic eye injury by seeking medical care

The eyes are at risk of being injured during head trauma. A direct blow to the eye, injury from broken bones that surround the eye, and a stabbing or scraping injury from a foreign object are all possible.

Eye structures that can be injured during head trauma include:

  • the bones and tissue around the eye
  • the front, outside surface of the eye
  • the eye’s interior
  • the back wall of the eye that reacts to light (retina)
  • the optic nerve at the back of the eye
  • the visual center of the brain in the occipital lobe

Whenever there is an eye injury it’s essential to seek emergency medical care. This is because sight can be gradually lost if there is bleeding, nerve damage or increasing pressure inside the eye. Scrapes to the front of the eye often become infected and then scar over, leading to loss of vision.

After an injury, emergency medical providers complete an initial eye exam, address any emergent conditions and then coordinate with the right eye specialist for additional care.

Damage to the Cornea

The cornea is a clear membrane that covers the colored portion of the eye. It has two key functions: protect the eye and help focus light toward the back of the eye.

Two common corneal injuries from head trauma are corneal abrasions and corneal lacerations. An abrasion happens when the cornea is scraped or scratched and some of the cells are sloughed off.

A laceration happens when a foreign object penetrates and cuts into the cornea.

It is extremely important not to remove a foreign object from the eye on one’s own, and instead have it removed by a medical professional. There are many delicate nerves and structures in the eye, and pulling the object out can cause further damage.

It is also very likely that the foreign object pushed bacteria, fungus or parasites into the eye. Starting treatment right away is important to avoid a serious eye infection.

Blunt Eye Injuries

Head trauma often results from blunt force. For example the head may be struck by a dashboard or by flying debris during an accident, by the ground or another person when playing sports, or by a fist during an assault.

The eye is filled with a gelatinous liquid, so when it is hit by blunt force it reacts in a similar way a water balloon would react. The impact pushes the front of the eye, the cornea, inward. The sides of the eye then expand outward. This can result in tears around the colored portion of the eye, the iris. When this happens it is called traumatic iritis.

Blunt eye injury from head trauma may harm the eye’s normal process of draining fluid. When the eye does not drain fluid properly, this is called glaucoma.

Glaucoma after traumatic eye injury is common and can, over months to years, lead to nerve damage at the back of the eye and permanent blindness.


Other injuries from blunt eye trauma include:

  • Rupture of the eye
  • Bruising of the light sensitive retina at the back of the eye (commotion retinae)
  • Detachment of the light sensitive retinal tissue at the back of the eye
  • Bleeding into the globe of the eye

Finally, the bones that surround and protect the eye may break when hit by blunt force. This will push the eye outward, or cause the eye to sink backward into the skull. Bone fragments may lacerate the eye itself.

Once again, this is an injury that must be evaluated immediately by emergency doctors or an eye specialist. Bone fragments can damage the nerve that runs from the back of the eye to the visual center of the brain. If this nerve is damaged or severed, permanent blindness will occur.


Khaw,P., Shah,P. & Elkington, A. (2004) Injury to the eye; BMJ. 2004 Jan 3; 328(7430): 36–38.

Leucona, K. (2005) Assessing and managing eye injuries; Community Eye Health. 2005 Oct; 18(55)

Morris, D. (2006). Ocular blunt trauma: loss of sight from an ice hockey injury Br J Sports Med. 2006 Mar; 40(3)

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