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OD3 (S1&2) > DIS - Eye Trauma I: Causes and Mechanical Injuries - Week 7 > Flashcards

DIS - Eye Trauma I: Causes and Mechanical Injuries - Week 7 Flashcards

1
Q

What are the three main sources of eye injury?

A

Mechanical
Chemical
Radiation/thermal

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2
Q

What are most eye injuries due to (2)?

A

Flying particles or blows to the head (mechanical injury)

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3
Q

Where do most eye injuries occur?

A

Workplaces

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4
Q

What are the most common eye injuries (what type)?

A

Corneal foreign body

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5
Q

What percentage of work-related eye injuries occurs in men?

A

90%

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6
Q

Which gender is more at risk for eye injuries and by how much (including one for severe eye injury)?

A

2x males
9x risk of severe eye injury requiring hospital admission

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7
Q

Between urban and rural, which is at a higher risk of eye injuries?

A

Rural

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8
Q

List the four kinds of contusion injuries.

A

Abrasions
Lacerations
Foreign bodies
Contusion injuries

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9
Q

List some common causes of conjunctival and corneal abrasions (11).

A

Fingernail scratch
Foreign body
Makeup brush
Papercut
Curling iron
Overexposure to UV light
Arc-welding
CL overwear, illfitting, torn
Trichiasis
Explosive truma
Chemical burn

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10
Q

List three symptoms of a conjunctival abrasion.

A

Minor irritation
Discharge
-watery
History

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11
Q

What do you expect to see with a conjunctival abrasion on slit lamp (4) and what should you always do (2)?

A

Abrasion with well defined borders
Underlying tissue intact with NaFl staining
Surrounding hyperaemia and/or chemosis
Always evert both eyes
Look at the other eye

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12
Q

Define corneal lacteration.

A

Cut of the cornea either partial or full thickness

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13
Q

Should corneal lacerations always be referred?

A

Yes

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14
Q

How are corneal lacerations generally managed (4)? What is a big risk with lacerations?

A

Sutures are used to close the laceration
-iris tissue put back into place
-lens may be removed
-stitches need to stay for some time
Infection is a risk

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15
Q

List 6 symptoms or corneal abrasions.

A

Gritty sensation through to severe pain
Lacrimation
Photophobia
Blepharospasm
Reduced vision
Redness

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16
Q

What layer are corneal abrasions generally?

A

Superficial
-epithelial or stromal

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17
Q

What do you expect to see on slit lamp of corneal abrasions (2)?

A

Opacity and oedema
Stain with NaFl

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18
Q

What are four differential diagnoses for corneal abrasions?

A

Infective or inflammatory corneal ulcers
Chemical/flash burn
Recurrent corneal erosion

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19
Q

How should corneal abrasions be managed (2)? Note the drug, duration, and dosage. What about in those wearing contact lenses?

A

Debride edges
-reduces RCE
Chlorsig qid
In CL wearers, chlorsig with gram negative antibiotic
-ciprofloxacin
14 days and 3 days after healed

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20
Q

Should corneal abrasions be patched? Explain why (2).

A

No
Epithelial healing is slowed and greater pain

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21
Q

Aside from antibiotics, list four treatment options for corneal abrasions.

A

Oral analgaesic
Lubricants (q1h/q2h)
Mydriatic if severe discomfort (atropine in office)
Bandage soft CL if loose tissue
-load first

22
Q

What is the review schedule for corneal abrasions (2)?

A

Review 24-48h then every 2-3 days

23
Q

How long should antibiotics be maintained for corneal abrasion treatment?

A

Until 3 days after epithelial healing

24
Q

What is the prognosis of corneal abrasions?

A

Good, but dependent on depth/location

25
What is a major cause of recurrent corneal erosions?
Previous corneal abrasion
26
What do patients with recurrent corneal abrasions typically complain of?
Pain on awakening
27
What is the cause of recurrent corneal erosions?
Faulty basement membrane
28
What is the management for recurrent corneal erosions (6)?
Debride the edges if not clean Lubricants, especially at night Ointment at night for many months Hyperosmotics Bandage contact lenses replaced fortnightly/monthly with antibiotics
29
What can be done for pain with recurrent corneal erosions (2)?
Icepacks Analgaesia
30
What are foreign bodies often classified into (4)?
Metallic or non-metallic Superficial or penetrating
31
What is the most common type of eye injury?
Foreign bodies
32
Are the majority of foreign bodies easily removed or is it difficult?
Easily removed
33
List 7 symptoms of foreign bodies.
No discomfort to severe pain (location dependent) Blepharospasm Epiphora Redness Photophobia Reduced VA History of trauma
34
When assessing a foreign body, what is it important to distinguish?
Penetrating or perforating
35
What should you always do when assessing a foreign body?
Lid eversion
36
What would you expect of patients with subtarsal foreign bodies (2)?
Pain on blinking (subjective) Vertical corneal abrasion
37
What are conjunctival or scleral foreign bodies often surrounded by?
Haemorrhages
38
What do you expect to see with corneal foreign bodies (2)?
Marked vascular injection near FB site Surrounded by a grey ring of infiltration and oedema
39
Describe the removal of a superficial foreign body (3).
Use anaesthetic and irrigation 25 gauge bent needle -spud, spatula, forceps, loop, burr, cotton bud
40
What is the treatment for foreign bodies after removal (6)? What about contact lens wearers? Note the review.
As with abrasions Broad spectrum antibiotic (4-6 drops loading dose, qid after) Cycloplegics Analgaesics NSAIDs Lubricants Review next day CL wearers as above with ciprofloxacin
41
What are the symptoms of intraocular foreign bodies ()?
As with superficial, but greater pain Impacted visions Oedema
42
What should you be careful of when assessing an intraocular foreign body?
Not to cause further damage
43
What is currently the most common cause of intraocular foreign bodies?
Violent behaviour -glass bottles
44
What are four signs of penetrating eye injury?
Seidel's sign Shallow AC Decreasing IOP AC inflammation
45
What are 4 things that could be done to assess intraocular foreign bodies?
Slit lamp Gonioscopy DFE CT scan
46
Do intraocular foreign bodies require referrals?
Yes
47
What is the prognosis for intraocular foreign bodies?
Poor
48
List 7 sequelae to penetrating eye injury.
Cataract Iris prolapse Hyphaemia Vitreous prolapse Retinal detachment Eyes enucleated Endophthalmitis
49
Should optometrists attempt to remove penetrating or perforating foreign bodies?
No, refer
50
Should penetrating or perforating foreign bodies be padded?
No, refer

OD3 (S1&2) (114 decks)

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