CORNEAL ABRASION

Question 1

Mechanism

Answer 1

Contact lense
Makeup brush
Foreign body blown into eye (driving, windy day, occupational)

Question 2

Clinical Features

Answer 2

Intense Pain (may be delayed several hours)
Foreign body sensation
Photophobia if associated iritis
Decreased visual acuity if central axis
Tearing

Lid Swelling
Blepharospasm
Conjunctival Injection
Irregular area of light reflection off the cornea
PERRLA or constricted pupils with irits
Superficial irregular corneal defect appearing bright
+/- flare and cells if abrasion is large and > 24 hrs old
-ve Seidel test
green irregular corneal defect under cobalt blue w/ fluorescein

Question 3

Clinical feature suggestive of retained foreign body under the upper lid

Answer 3

Multiple linear corneal abrasions
OR
Punctate keratitis

Question 4

Diagnostic Feature

Answer 4

Relief of pain with topical anesthetic

Question 5

Complications of damaged epithelium

Answer 5

Inflammatory Iritis
Globe Puncture

Question 6

Low long it takes to regenerate corneal epithelium

Answer 6

24-48 hrs

Question 7

Management: No contact lense

Answer 7

If abrasion > 2mm or very painful:
Cyclopentolate 1% Solution
1 drop in affected eye tid

Erythromycin 0.5% Ointment
Apply 1 cm ribbon to affected eye qid
5-7 days

Voltaren Opthalmic Solution
1 drop in affected eye qid

Apply Eye Patch

Question 8

Management: Contact Lense

Answer 8

If abrasion > 2mm or very painful:
Cyclopentolate 1% Solution
1 drop in affected eye tid

Ciloxan (Ciprofloxacin)
Solution:1-2 drops qid
5 days

Tobrex (Tobramycin)
0.3 % Solution: 1-2 drops q 4 h
0.3 % Ointment: 1/2 inch ribon to lower eyelid tid
5 days

Voltaren Opthalmic Solution
1 drop in affected eye qid

DO NOT Apply Eye Patch

Question 9

Management: Organic Matter

Answer 9

If abrasion > 2mm or very painful:
Cyclopentolate 1% Solution
1 drop in affected eye tid

Erythromycin 0.5% Ointment
Apply 1 cm ribbon to affected eye qid
5-7 days

Voltaren Opthalmic Solution
1 drop in affected eye qid

DO NOT Apply Eye Patch

Question 10

Indications for the eye patch

Answer 10

Corneal Abrasion
Bell’s Palsy

Question 11

Describe the application of the eye patch

Answer 11

Take 2 cotton oval eye pads
Fold in half
Close eyes
Stack oval eye pads on affected eye
Apply tape in X fashion
Have patient open eye
If affected eye is able to open, repeat eye patch

Question 12

Driving precautions with eye patch

Answer 12

Loss of depth perception
DO NOT DRIVE WITH EYE PATCH