Foreign Body removal Flashcards
how does the eye proect itself
even though its soft
surrounded by body
tha maxillary(cheek) and fontal/brow bone surrounds it
orbital fat also- absorbs impact
eyelashes and eyelid- from FB
teArs- reflex tearing
also the structure of cornea gives extra strength
corneal anatomy
outer epithelium- 5 layers- stratifies, squamous and NON keratinising, regenerates
bowmans memebrane- anterior condensation of the stroma
stroma- avascular, regular collagen fibrils - for strength and transparency, kerotyctes, mucopolysacharides, glycooprotein ground substances and nerves
descemets membrane- strong collagenous layer
endothelium- polygonal mono-layer
anterior chamber
classifying FBs
metal/non metal embedded/superficial penetrating/nonpenetrating solids/liquids/gas slow/fast projectile small/large- what about medium
sx of FB- include
wtarery- lacrimation photophobia- light sensitive Blepharospasm- lids shutting tightly redness- hypereamia blurred vision- reduced vision accute pain- sudden pain
how do u examine eye on slit lamp
diffuse then sclerotic scatter direct/indirect retro optic section- to see depth asses the inferior/siperior fornices eery the lids look at cornea/ pupil and also check fundus for any penetrating injuries also fl/lissamine green
if fb in epithelium
superficial staining
after 24hours- should disappear
if fb in stroma
stromal scar
can cause a loss of transparency in cornea
if its a metal fb
can cause a rust ring visual disturbance ?
always look at pupil
distortion of pupil- penetrates through cornea? to posterior region
blow out fracture
displacement of posterior eye
due to blunt object- orbital pessure increases
orbital floor normally fractures
Enopthalmos, restriction of eye movement, loss of sensation
surgery**
photo-keratits all known as arc eye welders flash photothalmia snow eye
this is not known straight away, latency period of 6hours
sx last a day- clear after 48 hours
give lubricant, pain killers
caused by uv light
but causes same sx as FB
also has increased sensitivity to exposure. i.e. a lower uv light each time has more effect. Whereas with skin- u increase tolerance- sunbathe for 15 mins one day, 1hour next, 5 hours next year etc etc obvs don’t sun bathe that long
what would photo-keratitis look like
punctate staining in epithelium-
SPK- sterile punctate keratitis- ie not infectious
recurrent erosion
where epithelium breaks away agin- due to dryness, overnight odeama? PAINFUL
lube, gel tears?
Alkali injury
DANGEROUS epithelial loss loss of corneal transparency ischeamia neovasculirasation- scarring- ulceration can lead to uveitis/glaucoama/cataract
acid injury
less serve due to self limiting coagulation of surface epithelium
iris dialysis
due to blunt trauma- causes iris to rip from the root
can also get iris strauma- from a FB
Hyphaema
Blood in anterior chamber
Hypopyon
White blood cells/ immune response-pus in anterior chamber
how do u prevent fb
advise px with protective eye wear
irrigate eye wen u have a chemical injury- most industrial companies have eye washes
also therapeutics- antibiotics- if epithelium defect
when would u need surgery
removal of fb- needs?
rust ring? dental burr/ needle
Photo-therapeutic keratectomy- to remove scarring
pterygium
small grey opacity
nasal usually
if temporal then probs trauma
conjuctiva overgrows the opacity and encroaches the cornea in a triangular manner
