If the injury caused a full-thickness defect in the eye wall (see Chap. 1.1), the treatment dramatically differs from that in a contusion. The two most important initial factors driving the surgeon's thought process1 and thus the management are the threat of ECH, which can rapidly cause irreversible loss of vision and eye (see Chap. 2.8), and the risk of endophthalmitis, which occurs in up to 5% of eyes with penetrating injuries2. The presence of an IOFB roughly doubles the risk [3, 4].

Depending on the type of injury, some of the damage occurs at the time of the trauma, and other complications develop later. Table 2.11.1 provides an overview; for comparison, contusions are also included. Obviously, the ophthalmologist is unable to undo damage already done, but his intervention3 has a major impact on subsequent events and thus on the prognosis.

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