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Signs and Symptoms
Men are five times more likely than women to receive conjunctival or scierai trauma.1,2 These types of injuries are most common in younger age groups: 54% of patients receiving them are younger than 40 years and only 10% are older than 60 years.1 Patients will present with a history of facial or direct ocular trauma, which may range from relatively mild to severe.3,4 Complaints range from mild pain to a scratchy, foreign-body sensation in the affected eye. There may be some tearing and photophobia; vision is rarely impaired unless the sciera is lacerated and the globe is open.4 The adjacent conjunctival vessels will be dilated, and there is often a subconjunctival hemorrhage. In conjunctival lacerations, there may be active bleeding, and the affected region of the conjunctiva appears torn. The edges of the compromised tissue may be retracted, revealing the underlying sciera. Fluorescein will pool in the area of the laceration under the cobalt filter. Eventually, stain will seep underneath the conjunctiva and produce a generalized "glow" to that part of the eye. In conjunctival abrasions, the denuded conjunctival epithelium will retain the vital dye, producing staining within the affected area.
Pathophysiology
The conjunctiva is an exposed mucous membrane covering the globe...