Spousal abuse rates around the world continue to rise despite many organizations dedication to preventing the violence. Not only can spousal abuse lead to depression, anxiety, and fear, but the physical damages can be devastating, and in some cases irreversible.
The head and face tend to be favorite targets of the men and women who commit this horrible crime. When a person is struck in the eyes, often times it is more than just a black eye that is the result. The damage that can be done to the eyes and orbital bones may result in vision loss, pain, and in extreme circumstances, eye enucleation – in other words the eye has to be removed.
A black eye is often a physician’s first indication that abuse may be present. This is especially true is a patients presents with back eyes often. For an ophthalmologist it’s just the surface; the real truths are found inside the eye. Here you will find a short list of the most common eye injuries that can occur as a result of spousal abuse.
Subconjunctival Hemorrhage: A subconjunctival hemorrhage is not something that alone is particularly damaging. This condition happens when the fragile blood vessels in the sclera (white part of they eye) are broken and bleed into the thin layers along the outside of the eye. The amount of blood can be an indicator of how forcefully a person was struck in the face. This is the one of the most common injuries seen with spousal abuse to the face, second only to back eyes.
Vitreous Hemorrhage: Another type of hemorrhage seen in people who have suffered spousal abuse is a vitreous hemorrhage. A vitreous hemorrhage is bleeding into the cavity that houses the jelly-like material in the back of the eye. Unlike a subconjunctival hemorrhage, a vitreous hemorrhage can be a sign of a potentially blinding condition such as a retinal tear. A person experiencing a severe vitreous hemorrhage would likely see a dramatic reduction in vision, a sudden appearance or increase in floaters (small back dots or lines in the vision), and flashes of light (if a retinal tear is present). While there is no ocular pain associated with a vitreous hemorrhage it should be evaluated immediately and may require surgery to restore clear vision.
Retrobulbar Hemorrhage: A retrobulbar hemorrhage is perhaps the most dangerous type of hemorrhage in the eye that is seen in victims of spousal abuse. The condition occurs when blood flows into the retrobulbar cavity behind the eyeball. This cavity is the small space which is formed by the back of the eyeball resting in the orbital bone. What makes a retrobulbar hemorrhage so dangerous is as the blood flows into the small cavity the amount of pressure builds and presses against the globe. With the pressure coming from behind the eye, there is not only the worry of an acute attack of glaucoma, but damage to the retina being forced to separate from the back of the eye (retinal detachment), and the possibility of the pressure being so great that it pushes the globe excessively far out of the socket. A retrobulbar hemorrhage can be extremely painful as the pressure behind the eye builds.
Traumatic Cataract: A cataract is forced when the lens in the eye develops opacities. Typically this only happen in people as they age, however in men and women that been on the receiving end of spousal abuse, a cataract can form simply from the trauma to the eye. People with traumatic cataracts as a result of injury see their vision decrease almost immediately. Cataracts are painless and left alone there will be no long term damage to the eye. Vision will continue to decrease until a person can only see light. Without surgery the vision will not return.
Retinal Detachment: Retinal detachments are potentially blinding conditions, and people who have been victims of spousal abuse to the face run a much higher risk than the common person. A retinal detachment is when the nerve layers pull away from the back of the inside of the eye. When the photosensitive nerves are disturbed vision loss occurs. May times a person with a retinal detachment will see flashes of light in their vision, an increase or appearance of floaters. Retinal detachments are similar to a retinal tear in that they are painless and will destroy vision. Even with prompt treatment vision may not return.
Open Globe: Of all the injuries that can result from spousal abuse, an open globe can be the most damaging and is the one of the most painful eye injuries a person can receive. An open globe occurs when an object pierces the eye or the force of a strong blow opens the eyeball. It is uncommon for a facial blow alone to cause an open globe, however, should the orbital bones around the eyes be fractured or broken, they can pierce the globe. Depending on the level of damage, an eye and/or vision may be saved. Unfortunately it is more common for the person to lose their vision and on occasion, the eye.
Spousal abuse can cause a multitude of problems and when the visually destructive nature of eye injuries is added the recovery can be an ever more difficult road. Vision loss in a normal person can cause depression; add in the stress of an abusive relationship and the depression is normally heightened.
It may be easy for people who are in abusive relationship to convince others that their black eyes are a result of a fall or a walk into a doorknob, however an ophthalmologist will likely know the truth. Should you experience any of the above listed symptoms, or suspect that you have any type of eye injury as a result of spousal abuse, seek medical or ophthalmic care from a licensed, medical eye doctor as soon as possible. If you, or someone on you know, is involved in an abusive relationship it is important to seek help before it is too late. Eye injuries and vision loss are debilitating, but losing ones life is more so.