MDT EYE Burns (Flash and Chemical) Flashcards

1
Q

Ultraviolet burns of the cornea are usually caused by what?

A

-use of a sunlamp without eye protection
-exposure to a welding arc
-or exposure to the sun when skiing
(“snow blindness”)

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2
Q

Your patient has some or all of these issues what would you suspect?

(a) Symptoms
1) Moderate-to-severe ocular pain, foreign body sensation, red eye, tearing, photophobia, blurred vision; often a history of welding or using a sunlamp without adequate protective eyewear.
2) Symptoms typically worsen 6 to 12 hours after the exposure. Usually bilateral.

(b) Signs
1) Critical: Numerous, punctate lesions or microdots on the corneal surface (after staining and under high magnification using the cobalt-blue light).
2) Other: Conjunctival injection, eyelid edema, corneal edema, miotic pupils that react sluggishly, and mild anterior chamber reaction.

A

Flash Burns (Ultraviolet Keratopathy)

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3
Q

What are some DDx for Flash burn?

A

(a) Toxic epithelial keratopathy (chemical)
(b) Thermal burn/keratopathy (boiling fluid, flame)
(c) Ocular foreign body
(d) Corneal abrasion

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4
Q

What Labs/Studies would you do for Flash burn?

A

(a) History (Welding, Sunlamp)

(b) Slit lamp examination: Use fluorescein stain. Evert the eyelids to search for a foreign body.

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5
Q

Your patient has some or all of these issues what would meds would you treat with?

(a) Symptoms
1) Moderate-to-severe ocular pain, foreign body sensation, red eye, tearing, photophobia, blurred vision; often a history of welding or using a sunlamp without adequate protective eyewear.
2) Symptoms typically worsen 6 to 12 hours after the exposure. Usually bilateral.

(b) Signs
1) Critical: Numerous, punctate lesions or microdots on the corneal surface (after staining and under high magnification using the cobalt-blue light).
2) Other: Conjunctival injection, eyelid edema, corneal edema, miotic pupils that react sluggishly, and mild anterior chamber reaction.

A

Pain treatment
Oxycodone 5mg Q 4-6 hours PRN severe pain

Antibiotic ointment: 4 to 8 times’ QD
(erythromycin or Trimethoprim/polymyxin B)

Consider a pressure patch for the more affected eye for 24 hours in reliable patients

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6
Q

Initial Care and Follow Up of Flash burns?

A

(a) All patients recover within 24–48 hours without complications.
(b) If a bandage soft contact lens was placed, the patient is seen in 1 to 2 days.

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7
Q

True/False
FLASH BURNS
Consider mild oral opioids for adequate pain relief as pain can be severe

A

True

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8
Q

True/False
FLASH BURN
Corneal epithelial healing will be faster if local anesthetic is prescribed

A

FALSE

Delay of corneal epithelial healing if local anesthetic is prescribed

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