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OD3 - Clinical Optometry Practice > 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
Q

What is a major cause of recurrent corneal erosions?

A

Previous corneal abrasion

26
Q

What do patients with recurrent corneal abrasions typically complain of?

A

Pain on awakening

27
Q

What is the cause of recurrent corneal erosions?

A

Faulty basement membrane

28
Q

What is the management for recurrent corneal erosions (6)?

A 
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
Q

What can be done for pain with recurrent corneal erosions (2)?

A

Icepacks

Analgaesia

30
Q

What are foreign bodies often classified into (4)?

A

Metallic or non-metallic

Superficial or penetrating

31
Q

What is the most common type of eye injury?

A

Foreign bodies

32
Q

Are the majority of foreign bodies easily removed or is it difficult?

A

Easily removed

33
Q

List 7 symptoms of foreign bodies.

A 
No discomfort to severe pain (location dependent)
Blepharospasm
Epiphora
Redness
Photophobia
Reduced VA
History of trauma
34
Q

When assessing a foreign body, what is it important to distinguish?

A

Penetrating or perforating

35
Q

What should you always do when assessing a foreign body?

A

Lid eversion

36
Q

What would you expect of patients with subtarsal foreign bodies (2)?

A

Pain on blinking (subjective)

Vertical corneal abrasion

37
Q

What are conjunctival or scleral foreign bodies often surrounded by?

A

Haemorrhages

38
Q

What do you expect to see with corneal foreign bodies (2)?

A

Marked vascular injection near FB site

Surrounded by a grey ring of infiltration and oedema

39
Q

Describe the removal of a superficial foreign body (3).

A

Use anaesthetic and irrigation
25 gauge bent needle
-spud, spatula, forceps, loop, burr, cotton bud

40
Q

What is the treatment for foreign bodies after removal (6)? What about contact lens wearers? Note the review.

A 
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
Q

What are the symptoms of intraocular foreign bodies ()?

A

As with superficial, but greater pain
Impacted visions
Oedema

42
Q

What should you be careful of when assessing an intraocular foreign body?

A

Not to cause further damage

43
Q

What is currently the most common cause of intraocular foreign bodies?

A

Violent behaviour

-glass bottles

44
Q

What are four signs of penetrating eye injury?

A

Seidel’s sign
Shallow AC
Decreasing IOP
AC inflammation

45
Q

What are 4 things that could be done to assess intraocular foreign bodies?

A

Slit lamp
Gonioscopy
DFE
CT scan

46
Q

Do intraocular foreign bodies require referrals?

A

Yes

47
Q

What is the prognosis for intraocular foreign bodies?

A

Poor

48
Q

List 7 sequelae to penetrating eye injury.

A 
Cataract
Iris prolapse
Hyphaemia
Vitreous prolapse
Retinal detachment
Eyes enucleated
Endophthalmitis
49
Q

Should optometrists attempt to remove penetrating or perforating foreign bodies?

A

No, refer

50
Q

Should penetrating or perforating foreign bodies be padded?

A

No, refer

OD3 - Clinical Optometry Practice (114 decks)

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