Eye Trauma Flashcards
a patient presents with history of trauma to the eye, decreased visual acuity, teardrop pupil, increased/decreased anterior chamber depth, low IOP, extrusion of vitreous fluid, and external prolapse of internal ocular structures. what is their most likely diagnosis?
globe rupture
what is a globe rupture most likely caused by?
- high velocity blunt trauma
- injury from sharp object
where does a global rupture cause the damage?
behind the insertion of the rectus muscles
what test can be done in a patient with global rupture that does not have an obvious teardrop pupil?
seidel’s test
what does a seidel’s test show in a patient with a ruptured globe?
fluorescein moves away from ruptured globe
what are two things we should avoid in a patient with a possible globe rupture?
- avoid applying pressure with exam
- avoid removing foreign body
what should we do for a patient with a global rupture?
call ambulance to transport to ER for ophthalmology
what will ophthalmology do for a patient with a global rupture? (3)
- eye shield
- opioids for pain
- treat n/v
why does ENT emphasize treating n/v in a patient with a globe rupture?
to avoid extrusion of ocular contents
blood in the anterior chamber due to either blunt force trauma or a penetrating wound
hyphema
why does blood stop quickly in a patient with a hyphema?
increased IOP and clot formation
a patient presents with history of trauma to the eye, vision loss, eye pain, n/v. what is their most likely diagnosis?
hyphema
during physical exam, you see blood in the anterior chamber, photophobia, decreased visual acuity, anisocoria, iridodialysis, and increased IOP. what is the most likely diagnosis?
hyphema
what is the management for a patient with hyphema? (4)
- eye shield
- elevated bed rest
- dim lighting
- treat n/v and pain
what should be avoided in a patient with a hyphema?
NSAIDs
an eye injury that is due to eye trauma by foreign body or improper contact lens use
corneal abrasion
a patient that presents with severe eye pain, foreign body sensation, but cannot pinpoint the onset, is most likely experiencing what?
corneal abrasion
what 5 physical exams should I do for a patient with a corneal abrasion?
- lid eversion for FB
- visual acuity
- penlight exam
- extraocular movements
- fluorescein stain for scratch
what is the treatment for a patient with a noncomplicated corneal abrasion? (2)
- ointment antibiotic
- topical or oral NSAIDs
which 2 ointment antibiotics should a contact wearer who has a corneal abrasion use?
- ciprofloxacin
- ofloxacin
why must contact wearers with a corneal abrasion be put on a floxacin?
cover for Pseudomonas
which ointment antibiotic should a non-contact wearer who has a corneal abrasion use?
erythromycin
what should be avoided in a patient that has a corneal abrasion?
do not patch the eye
eye trauma that is round on staining and looks like a white or opaque spot with a penlight or direct inspection
corneal ulcer
what should I do for a patient with a corneal ulcer?
refer
