13 - Opth - Trauma - Penetration trauma + chemical injury

Question 1

PT -do what urgently

Answer 1

refer

Question 2

PT - when to suspect this

Answer 2

history of tool/metal work

Question 3

PT - Signs of full thickness penetration - 7

Answer 3

Hx (sharp/high velocity injury)
distorted globe
subconjunctival haemorrhage
distorted iris/pupil
iris prolapse
hyphaema (blood in ant chamber)
Seidels sign

Question 4

PT - What is seidels sign

Answer 4

clear streak of aqueous in flourescein-stained area

Question 5

PT - What not to do

Answer 5

DO NOT touch, manipulate or pad the eye - immediate surgery required

Question 6

PT - serious risk of?

Answer 6

endophthalmitis - local and systemic AB’s

Question 7

Chemical injury - which are more serious and why

Answer 7

alkali more serious - risk of penetrating injury

-acids coagulate protein and show slower penetration

Question 8

CI - Signs of chemical injury

Answer 8

redness, pain, blurring, photophobia

cloudy cornea

Question 9

CI - What to do immediately

Answer 9

irrigate eyes - local may be needed first, use clean water/normal saline, before Hx or exam

Question 10

CI - what to check regularly

Answer 10

pH using litmus paper - both for comparison

Question 11

CI - complications of chemical injury

Answer 11

corneal scarring
opacification
lid damage