Lecture 6: Accident and emergency Flashcards
What is worse, acid or alkali to the eye?
Alkali is worse because it breaks down hemidesmosomes and gets between tissues, acid will mess with proteins.
Why must you assess the limbus of the eye in trauma or burn etc?
Because it contains stem cells for epithelium, without them the tissue will fibrose
What are the four ophthalmic emergencies?
Acute closed angle glaucoma, giant cell arteritis, endothalmitis and bacterial keratitis are the four ophthalmic emergencies.
What must you assess for in a trauma to the orbit?
Checking for orbital floor fractures to rule out cranial nerve or muscle entrapment.
Whats the risk of using steroids in the eye?
If there is an infection present it can exacerbate things and lead to cataracts or glaucoma. Must be treating with abx or antivirals.
How is herpes zoster of the eye treated?
Systemic antivirals with topical steroids unless dendritic ulceration present as can worsen
In burns of the eye what else must be given?
Atropine to dilate the ciliary bodies to prevent spasm due to inflammation and also posterior synechiae
What is the limbus?
Junction b/w iris and sclera
What are the findings and investigations for a suspected uveitis?
- Adhesions between iris and anterior lens, Keratic precipitates, ciliary flush are all findings
- Investigations: HLA-B27
Always check for autoimmune conditions
Why does the cornea go hazy in acute closed angle glaucoma?
Because no fluid movement\
What can cause sudden onset painless loss of vision?
- CRVO/BRVO
- CRAO/BRAO
- Retinal Detachment
- Ischaemic optic neuropathy
- Optic neuritis
What causes ischaemic optic neuropathy?
Giant cell arteritis
In central retinal artery occlusion what else should you examine for?
Carotid bruits and vascular disease
How does optic neuritis present, tx and what can cause it?
- Optic neuritis: Curtain of vision loss. IV high dose steroids. MS is common precipitant.
How is retinal detatchment treated?
Laser weld, gas bubble, vitrous replacement
