We recently discussed the types of eye injuries workers may suffer. We continue here by explaining based on input from Invision some of the signs and symptoms workers should seek help for – and some of the likely treatments.
- Chemical exposure. Some of the signs to look for are redness of the eye, profuse tearing of the eyes, and swollen eyelids. Symptoms include pain and intense burning.
- Subconjunctival hemorrhage (bleeding). This injury generally doesn’t affect a persons’ vision. “The eye will have a red spot of blood on the sclera (the white part of the eye). This occurs when there is a rupture of a small blood vessel on the surface of the eye.” The appearance can be alarming. If there are no other signs of trauma, this condition nearly clears up in 4-10 days without treatment.
- Corneal abrasions: Symptoms often include pain, a feeling that there is something in the eye, light sensitivity, and tearing.
- Iritis: Signs of this eye injury include sensitivity to light and pain which feels like a deep ache. The tearing may be excessive.
- Hyphema. Symptoms include blurry vision and pain.
- Orbital blowout fracture: Symptoms include pain, double vision, and swelling of the eyelid that may get worse after blowing your nose. The upper lip may also become numb. The eye may bruise and swell.
- Black eye. This condition is due to “blood polling in the eyelids.”
- Conjunctival lacerations. Like many eye injuries, symptoms include redness, pain, and a feeling that something is in the worker’s eye.
- Lacerations to the cornea and the sclera. Reduced vision and pain are common symptoms.
- Foreign bodies. Symptoms of a “foreign body in the cornea are a sensation that something is in the eye, tearing, blurred vision, and light sensitivity.” In some cases, the foreign body is visible.
- Intraorbital injuries. Symptoms include pain, reduced vision, and double vision. The symptoms commonly appear hours or days after the workplace injury. There may be no symptoms at all.
- Intraocular injuries. “People may have eye pain and decreased vision, but initially, if the foreign body is small and was introduced into the eye at high velocity, people may have no symptoms.”
- Light-based injuries.
- Ultraviolet keratitis. “Symptoms include pain, light sensitivity, redness, and an intense feeling that something is in the eye.” Symptoms usually appear about four hours after exposure.
- Solar retinopathy:Symptoms include “decreased vision with a small area of central blurring.”
How are eye injuries diagnosed?
Doctors will begin by taking an oral examination to understand what happened. Normally, an ER doctor or an ophthalmologist conducts the examination. The examination also includes placing a dye or stain “into the tear-lubricated area that normally lubricates the eye.” “The dye is called fluorescein, which stains those areas of the cornea that have been damaged. When the blue light is shined into the eye, corneal abrasions turn green in appearance.” The ER doctor or ophthalmologist uses a “slit lamp” which is essentially a “special magnifying and illuminating microscope” to examine the eye.
X-rays may be used if an orbital fracture, intraocular, or intraorbital foreign body is suspected.
Some self-care treatments may be available but since vision is so critical to any person’s life, the best course of action is to seek medical help as quickly as possible. Your vision could be at stake.
What medical treatments are used?
The ER doctor or ophthalmologist will normally consider the following types of medical care depending on the type of injury:
- Exposures to chemicals. The doctor will irrigate the eye, possibly with a special device resembling a contact lens used for continuous eye irrigation termed a Morgan lens.” The treatment will vary depending on the chemical involved and how serious the injury is. For some exposures, the doctor may dilate the pupils with special eye drops and prescribe medication.
- Subconjunctival hemorrhage. Treatment for this injury is fairly minor – reassurance, time, and advising the patient not rub his/her eyes.
- Corneal abrasions. The doctor may use numbing eyedrops to examine the eye. ” Although medicated eyedrops remove the pain, they cannot be used at home to control pain. The anesthetic drops actually delay healing. Repeated use will damage the cornea.” Doctors will likely dilate the pupil with drops and antibiotic ointments to avoid secondary infections. An eye patch may be recommended. The advantage of a patch is that may provide relief and quicken the healing process. The downside is that the patch may increase the risk of an infection.
- Traumatic iritis. For this injury, the doctor will dilate the pupil to examine it. Steroid eye drops may help reduce inflammation
- Hyphema. Some workers may need to be hospitalized. Others may need to manage their condition at home – after consultation with an ophthalmologist.
- Orbital blowout fractures. This injury normally requires “i ce and elevation of the head for 48 hours.” To reduce the swelling. “Some ophthalmologists use nasal decongestants and oral antibiotics for one to two weeks.” Surgery may be required once the swelling goes down.
- Lacerations. Sutures may be required depending on the location and size of the cut. “Lacerations to the eyeball often require antibiotics, sutures, and more extensive surgery in an operating room setting. Consultation with an ophthalmologist is recommended.”
What complications may result from an eye injury?
Complications vary depending on many factors. In the worst case, a worker may lose his/her vision if he/she is exposed to chemicals such as strong acids or alkalis.
Patients generally recover from subconjunctival hemorrhage, corneal abrasions, and traumatic iritis. Hyphema can result in vision loss and glaucoma. An orbital blowout fracture may require surgery. Lacerations generally heal well though scarring and infections are concerns. Lacerations of the eyeball have a “guarded prognosis.”
If the eye has a foreign body in it, the cornea may scar. Normally, vision problems are not common. If the foreign object is in the “inside the globe of the eye or in the orbit” then complications may ensue. Workers with eye injuries due to exposure to ultraviolet keratitis generally recover. “Solar retinopathy has no medical or surgical treatment.” The “prognosis depends on the amount of exposure from sun gazing. Permanent loss of vision can occur because of retinal damage.”
Patients with minor eye injuries treat with a family doctor or ER doctor. For more serious eye injuries, it is necessary to see an ophthalmologist. Patients with scarring or disfigurement may also need to treat with a facial plastic and reconstructive surgeon.
What kind of Workers Compensation Benefits Can an Injured Worker Recover for an Eye Injury?
We previously touched on this subject with respect to recovery of North Carolina Workers Compensation Benefits for Vision loss.
Generally, the type of benefits that can be recovered, first depends on whether the claim is accepted by the workers compensation insurance company. If it is denied, the injured worker may have to proceed to a hearing to recover. In addition, as with any injury, the amount of recovery, if any, will also depend on the degree to which the eye injury impacts the injured worker’s ability to engage in his or her pre-injury employment. This, in turn, will depend on the severity and character of the eye injury. In other words, what aspects of vision were damaged in the accident? The next question: How critical is good vision to performance of the injured worker’s pre-injury job?
For instance, if one is a trucker and the vision impairment from the injury is such that the truck driver is no longer able to obtain a CDL License, this would be an impairment that would indicate that the worker can no longer return to his or her pre-injury job due to the work injury.
In those circumstances, if the worker is under an Award or Accepted Claim, he or she would be entitled to up to 500 weeks of weekly checks at the rate of 2/3 rds of his or her average weekly wage, in addition, of course, to lifetime medical benefits for the eye injury; HOWEVER, if the injury is to BOTH eyes, or to one eye and in addition, certain other body parts, such as a leg, foot, arm, or hand, injured in the same accident, then in Virginia, depending on the severity of the injuries to each of those parts, the worker may qualify for permanent and total weekly benefits, which would meanfor life, not just the 500 week limitation.
Of course, any worker’s entitlement to ongoing benefits—even in an Awarded or Accepted claim, can be affected, decreased, or even stopped by any number of factors, the most common of which the insurance carrier subjecting the worker to vocational rehabilitation and obtaining for that worker a light duty job, which would reduce or in some cases eliminate the carrier’s obligation to pay weekly benefits.
The severity of an eye injury is measured under Workers Compensation law by the degree of injury and it is measured in terms of the vision loss, assuming that loss is permanent. So, what will typically occur is the injured worker will receive a permanency rating by his or her treating eye physician based on the level of vision post-injury.
Even if the injured worker has returned to work full time work, if he or she gets a permanency rating on the vision loss, then in Virginia, the injured worker may be entitled to up to 100 weeks of compensation at the rate of 2/3rds of their average weekly wage for permanent vision loss in Virginia. Note that under North Carolina Workers Compensation Vision Loss Claims, the maximum number or weeks is slightly higher, at 120 weeks.
But the rating is also important because, in Virginia (NOT in North Carolina) in relation to injuries to both eyes, or one eye and another body part, the rating could determine whether or not one is entitled to permanent and total benefits. For instance, a combination of a 5% permanent vision loss rating with a 15% lower extremity rating is not going to allow anyone to bring a successful claim for permanent and total benefits. But change those numbers to 50-60% each, and that is something else.
How do doctors know what percentage to assign to the Vision Loss?
The Virginia Workers Compensation Commission has assigned specific impairments based on the level of permanent vision impairment and is contained in the Virginia Workers Compensation Claims Services Reference Material on the section relating to Vision loss. Essentially there is a chart which takes us from a rating of 0% for 20/20 Vision to a rating of 100% for 20/200 Vision. In between are the gradations of impairment and percentages, based on the level of permanent vision loss.
At Joe Miller Law Ltd., we represent employees in Virginia and North Carolina who have any type of injuries including injuries that may result in permanent damage such as vision loss. We’ve helped thousands of workers obtain all the worker’s compensation benefits they deserve. To discuss any workplace accident or occupational illness claim, call lawyer Joe Miller, Esq., at888-667-8295 or use my online contact form to schedule an appointment.
Our firm currently uses remote for clients who don’t want to meet in person. To use our remote services, please look at our New Electronic Case Review.
