Eye Trauma

Question 1

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?

Answer 1

globe rupture

Question 2

what is a globe rupture most likely caused by?

Answer 2

1. high velocity blunt trauma
2. injury from sharp object

Question 3

where does a global rupture cause the damage?

Answer 3

behind the insertion of the rectus muscles

Question 4

what test can be done in a patient with global rupture that does not have an obvious teardrop pupil?

Answer 4

seidel’s test

Question 5

what does a seidel’s test show in a patient with a ruptured globe?

Answer 5

fluorescein moves away from ruptured globe

Question 6

what are two things we should avoid in a patient with a possible globe rupture?

Answer 6

1. avoid applying pressure with exam
2. avoid removing foreign body

Question 7

what should we do for a patient with a global rupture?

Answer 7

call ambulance to transport to ER for ophthalmology

Question 8

what will ophthalmology do for a patient with a global rupture? (3)

Answer 8

1. eye shield
2. opioids for pain
3. treat n/v

Question 9

why does ENT emphasize treating n/v in a patient with a globe rupture?

Answer 9

to avoid extrusion of ocular contents

Question 10

blood in the anterior chamber due to either blunt force trauma or a penetrating wound

Answer 10

hyphema

Question 11

why does blood stop quickly in a patient with a hyphema?

Answer 11

increased IOP and clot formation

Question 12

a patient presents with history of trauma to the eye, vision loss, eye pain, n/v. what is their most likely diagnosis?

Answer 12

hyphema

Question 13

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?

Answer 13

hyphema

Question 14

what is the management for a patient with hyphema? (4)

Answer 14

1. eye shield
2. elevated bed rest
3. dim lighting
4. treat n/v and pain

Question 15

what should be avoided in a patient with a hyphema?

Answer 15

NSAIDs

Question 16

an eye injury that is due to eye trauma by foreign body or improper contact lens use

Answer 16

corneal abrasion

Question 17

a patient that presents with severe eye pain, foreign body sensation, but cannot pinpoint the onset, is most likely experiencing what?

Answer 17

corneal abrasion

Question 18

what 5 physical exams should I do for a patient with a corneal abrasion?

Answer 18

1. lid eversion for FB
2. visual acuity
3. penlight exam
4. extraocular movements
5. fluorescein stain for scratch

Question 19

what is the treatment for a patient with a noncomplicated corneal abrasion? (2)

Answer 19

1. ointment antibiotic
2. topical or oral NSAIDs

Question 20

which 2 ointment antibiotics should a contact wearer who has a corneal abrasion use?

Answer 20

1. ciprofloxacin
2. ofloxacin

Question 21

why must contact wearers with a corneal abrasion be put on a floxacin?

Answer 21

cover for Pseudomonas

Question 22

which ointment antibiotic should a non-contact wearer who has a corneal abrasion use?

Answer 22

erythromycin

Question 23

what should be avoided in a patient that has a corneal abrasion?

Answer 23

do not patch the eye

Question 24

eye trauma that is round on staining and looks like a white or opaque spot with a penlight or direct inspection

Answer 24

corneal ulcer

Question 25

what should I do for a patient with a corneal ulcer?

Answer 25

refer