2 - ocular trauma Flashcards
what are causes of blunt trauma to eye? (basically list causes)
- blowout fracture
- haemorrhage (from globe rupture)
- traumatic uveitis
- hyphaema (blood in anterior chamber)
- tearing of intraocular laceration (ciliary muscle tears) - cause lens dislocation
- retinal detachment
- bruising of retina (commotio retinae)
what should be done if see hyphaema?
hyphaema = blood in anterior chamber
- it indicates something wrong so should refer to ophthalmology
what is retinal detachment?
type of blunt trauma which can lead to tear & fluid detaching retina = looks pale & crinkled on fundoscopy
what are ways eye can be damaged from penetrating trauma?
- penetrating orbital injury
- lid laceration
- corneal laceration
- penetrating injury (leak with fluorescein)
- scleral laceration
- sympathetic ophtalmia
how do you test for penetrating injury?
put fluorescein on surface of eye - you then will see dilution of fluorescein, the aqueous humour (from tear) mixes with fluorescein making waterfall effect
what is sympathetic ophthalmia?
if penetrating injury to 1 eye then immune reaction doesn’t always understand that just 1 eye in danger so causes inflammation to both eyes = can make bilateral blindness (also can happen after multiple surgeries on 1 eye)
- this is rare but very important to be aware of
what are some locations for small foreign bodies?
- subtarsal (under upper eyelid)
- conjunctival
- corneal (common)
- penetrating foreign body
how would you remove corneal foreign body?
use slit lamp, lots analgesia and scrape/scoop it out. cover chloramphenicol for recovery
when should you be suspicious of penetrating foreign body?
- irregular pupil
- anterior chamber shallow
- localised cataract
- gross inflammation
what should be the 1st thing to do if suspect penetrating foreign body?
imaging
is alkali or acid burn more worrying?
alkali
what do you worry about getting ischaemia in alkali burn?
limbus ischaemia = has limbo stem cells that fix cornea, if ischaemia then cornea can’t be fixed and stays cloudy forever
what is management of chemical injury?
- history
- pH
- irrigate!! (at least 2L saline or until pH normal)
- assess slit lamp
