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Ophthalmology Week 2 2017/18 > 2: Ocular trauma > Flashcards

2: Ocular trauma Flashcards

1
Q

Where do the majority of eye injuries occur?

A

At work

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2
Q

What are some mechanisms of eye injury?

A

Blunt force trauma

Penetrating injuries

Burns

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3
Q

What must be recorded before examining the eyes of someone with an injury?

A

Visual acuity

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4
Q

How is the eye examined?

A

Front to back

lids, conjunctiva, cornea, anterior segment, pupils, fundus

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5
Q

What dye is used to examine the eyes?

What colour does it turn under blue light?

A

Fluorscein

green

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6
Q
  1. History is key
  2. Visual acuity
  3. Fluorescein
A
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7
Q

What type of fracture can be caused by orbital trauma?

A

Orbital blowout fracture

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8
Q

What sign is produced on a CT head by an orbital blowout fracture?

A

Tear drop sign

prolapse of fat into maxillary sinus

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9
Q

Which walls of the orbit are most commonly damaged by orbital blowout fractures?

Which muscle is commonly trapped?

A

Medial and inferior walls

Inferior rectus

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10
Q

What sign is caused by inferior rectus entrapment in an orbital blowout fracture?

What symptom does this cause?

A

Inability to ELEVATE affected eye because muscle is trapped (contracted)

Diplopia

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11
Q

What type of bleeding is caused by blunt force trauma?

A

Subconjunctival haemorrhage

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12
Q

What should you be suspicious of in all traumatic eye injuries involving significant force?

A

Globe rupture

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13
Q

What is traumatic uveitis?

A

Inflammation caused by proteins released by traumatic injury

think also: sympathetic ophthalmia

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14
Q

What is blood in the anterior chamber called?

What does it indicate?

What is pus in the anterior chamber called?

A

Hyphaema

Significant intraocular injury

Hypopyon

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15
Q

What’s this?

A

Dislocated lens

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16
Q

What’s this?

A

Retinal detachment

17
Q

What’s this?

A

Choroid tear

18
Q

What is commotio retinae?

A

Bruised retina

19
Q

What name is given to a bruised retina?

A

Commotio retinae

20
Q

What is a laceration?

A

Deep cut/tear in surface

21
Q

Corneal lacerations cause a communication between the outside world and the eye.

What can this cause?

What sign is produced on fluorescein staining?

A

Infection

Seidel test (aqueous fluid passes through communication and dilutes the fluroscein)

22
Q

In what situation may the pupil become teardrop shaped?

A

Corneal laceration

Iris acts like omentum in Crohn’s, plugging the injury

23
Q

What is the Seidel test?

A

Dilution of fluorescein

Caused by corneal laceration, aqueous fluid passing through communication

24
Q

What autoimmune disease causes bilateral granulomatous uveitis in response to trauma in one eye?

What may it result in if untreated?

A

Sympathetic ophthalmia

Total blindness

25
Q

What part of the anterior eye must be examined for foreign bodies?

A

Underneath upper lids

eye-e sub-tarsal

26
Q

What will occur if residual metal is left in the cornea?

A

Rust ring

27
Q

What medication is usually used for corneal abrasions / foreign bodies?

What are the two benefits of this?

A

Chloramphenicol drops QDS for a week

Antibacterial and moisturising

28
Q

What investigation should be done to find intraocular foreign bodies?

A

X-ray orbits

29
Q

(Acids / alkalis) cause more damage to the eye.

Why?

A

Alkalis

Rapidly penetrate, severely burn and cause scarring

Acid burns are self-limiting

30
Q

Where are stem cells found in the eye?

A

Limbus

31
Q

Alkali burns cause limbal ___.

Why is this so serious?

A

limbal ischaemia

only source of stem cells

32
Q

Is the cornea usually vascularised?

A

No

so corneal vascularisation is a sign of serious injury

33
Q

What two common chemicals are very alkaline and can cause chemical burns?

A

Lime

Cement

34
Q

How are chemical burns treated?

A

Toxbase

pH paper

Slit lamp assessment

35
Q

How do you treat lime / cement burns?

A

Physically remove

DON’T IRRIGATE because they create alkaline solutions which will make things worse

36
Q

How are chemical burns treated?

A

Irrigate with at least 2L of saline

Keep checking pH throughout

37
Q

A high percentage of eye injuries are ___.

A

preventable

38
Q

How are eye injuries prevented?

A

Safe practice - goggles, training, guidelines

Education

Ophthalmology Week 2 2017/18 (8 decks)

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