Foreign Body Removal (M4) Flashcards
What are the indications of conjunctival/ocular irrigation?
- chemical burns
- foreign body
- discharge removal
- gonioscopy or tonometry
What is the order that irrigation of the eye should take place?
- inferior
- nasal
- superior
- temporal
How long must irrigation occur for chemical burns?
30 min
For conjunctival foreign body removal, what is the procedure?
- try to irrigate first
- look for corneal foreign body tracks with NaFl
- Always evert lids (most commonly in superior palpebral)
- Use Q-tip then spud or needle, scrapping downward
- Assess and document
What needs to be assessed and documented for conjunctival foreign body removal?
- number
- location
- degree of embeddedness (depth)
What are the major things to consider in a corneal foreign body removal?
- how fast was the FB travelling
- what was the FB
- location of FB
- pain
What are the examination techniques used in corneal foreign body removal?
- optic section at site of FB
2. DFE as indicated by velocity of FB
What position should the spud/needle be held to the cornea in FB removal?
tangential
How quickly will metallic FB oxidize after becoming embedded in the cornea?
12-24 hrs
What usually surrounds a corneal rust ring?
corneal edema
What should be used to evaluate the cornea integrity? 1. What are you looking for? 2
- fluorescein strip and sterile saline
2. epithelial involvement and Seidel’s sign
When will a scar definitely be present for a corneal FB?
embedded in Bowman’s layer or deeper
What is the purpose of therapeutic pressure patching?
immobilize the eyelid in order to reduce discomfort and promote corneal healing
What are the indications for therapeutic pressure patching?
- Tx of corneal injuries
- temporary protection post-surgical
- metallic coverage post-ocular injury
What are contraindications of therapeutic pressure patching?
- CL wearers
- active infection
- penetrating injury
What are the side effects of therapeutic pressure patching?
- SPK
- corneal edema
- skin irritation
What are the types of silicone hydrogel CL’s used as bandage CL’s?
- air optix Night and Day
- Purevision
- Oasys
What are the contraindications for bandage CL’s?
active infection/ulcer
What are the negatives of pressure patching?
- loss of depth perception
- creates microbe friendly environment
- promotes hypoxia
What is the typical treatment of a retention cyst?
no treatment common
Is lymphatic cyst drainage by an optometrist allowed in Ohio?
no
What is the equipment used for lymphatic cyst drainage?
- slit lamp
- 25G needle
- topical anesthetic
- 2.5% phenylephrine
- broad spectrum antibiotic for 2 days after
What are the indications for corneal sensitivity testing?
- Herpes simplex keratitis
- Herpes zoster keratitis
- long-term CL wear
- dense corneal scars
- neurotrophic keratitis
- various systemic diseases
What is the corneal sensitivity tester that uses a nylon monofilament?
Luneau Cochet-Bonnet Aesthesiometer
