Even if the blunt object's impact was insufficient to cause a full-thickness defect in the eye wall (rupture; see Chaps. 1.1, 2.12), the delivered energy can still seriously damage any tissue of the eye by compressing it and by transferring its energy into "shockwaves" that can reach the posterior pole. The consequences may present acutely or several years later. Chronic problems are especially common if the initial management was inappropriate.
Contusions must be taken seriously, although they do not invoke the same urgency as open globe trauma does: the surgeon has time to evaluate the eye and carefully select the best management option (see Chap. 1.8). The severity of contusions was well demonstrated in a large study, which found the following complication rates: retinal detachment 44%; contusion retinopathy 21%; vitreous hemorrhage 11%; choroidal rupture 8%; evulsion of the optic nerve 1% .
Selected consequences caused by a contusion are summarized and compared with damage inflicted by open globe injuries are shown in Table 2.11.1.
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