Eye Trauma

Question 1

What is the physiology of blunt trauma to the eye?

Answer 1

Blunt trauma (e.g. football, paintball, punch), compresses the eye antero-posteriorly and stretches it equatorially.

Primarily impacts the lens and iris but can damage the posterior pole of the eye.

Question 2

What is the physiology of penetrating (open globe) injury to the eye?

Answer 2

Often penetrates the cornea or sclera

Features that suggest a penetrating injury:
Subconjunctival haemorrrhage
Laceration
Distorted iris or pupil
Distorted globe

Question 3

What is the management of penetrating (open globe) injury to the eye?

Answer 3

Do not check IOP
Do not remove FB
Do not touch or manipulate the eye
Refer immediately: for antibiotic cover and surgery 
Avoid any increased pressure in the eye 

X-Ray may be needed if there is a foreign body

Question 4

Describe chemical burns in eye injuries. What is the management?

Answer 4

Acid: acid precipitates tissue proteins therefore there is a barrier to further injury

Alkali: more severe, cause corneal damage by pH change, ulceration and proteolysis. fucks the whole of your eye up basically

Management: IRRIGATION (may be up to 20L). Local anaesthetic drops. pH testing.