MDT Eye Corneal Abrasion and Ulcer Flashcards
Corneal epithelium regenerates quickly, so healing time for abrasions is short, usually within how many hours?
24 to 48 Hours
Patient has these issues what would you suspect?
(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).
Corneal Abrasion
Patient has these issues what Labs/studies would you perform?
(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).
Slit lamp to identify dimensions of abrasion.
Corneal Abrasion Differential Diagnosis:
(1) Conjunctival abrasion
(2) Subconjuctival hemmorrhage
(3) Foreign body
Patient has these issues
(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).
WHAT antibiotics would you order for a non-contact lens wearer?
Antibiotic ointment (e.g., erythromycin, bacitracin, or bacitracin/polymyxin B q2– 4h) OR Antibiotic drops (e.g., polymyxin B/trimethoprim or a fluoroquinolone)
Patient has these issues
(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).
WHAT antibiotics would you order for a contact lens wearer?
Fluoroquinolone drops
Topical nonsteroidal anti-inflammatory drug (NSAID) drops for Corneal Abrasion
Ketorolac 0.4% to 0.5% q.i.d. for 3 days) for pain control
Pain management for Corneal abrasion
Oral acetaminophen or NSAIDs
True/False
Debride loose or hanging epithelium because it may inhibit healing
True
True/False
Your Patient can continue to wear their contacts while healing from a corneal abrasion.
False
They should not wear contact lenses
Corneal Abrasion Follow Up
(a) Follow up in 24 hours (or sooner if the symptoms worsen) for re-evaluation.
(b) Revisit every 3 to 5 days until healed.
Corneal Abrasion Complications:
(1) Corneal ulcer
2) Development of infection (Iritis
Corneal ulcer is also known as what?
Infectious keratitis
What is the biggest risk factor for corneal ulcer
improper contact lens use
Causative Organisms for Corneal ulcers
Bacteria:
Pseudomonas aeruginosa,
Streptococcus pneumoniae,
Staphylococcus species,
Moraxella species
Patient has these issues, what would you suspect
(a) Erythema and edema of lids and conjunctivae; discharge; ocular pain or foreign body sensation; photophobia; or blurred vision.
(b) Visual acuity is decreased if the ulcer is located in the central visual axis
(c) Cornea reveals a round or irregular opacity or infiltrate – classically central in location
(d) Severe cases may have hypopyon (white, hazy base - due to WBC infiltration)
(e) Fluorescein reveals staining epithelial defect
corneal ulcer
Patient has these issues, what Antibiotics would you give?
(a) Erythema and edema of lids and conjunctivae; discharge; ocular pain or foreign body sensation; photophobia; or blurred vision.
(b) Visual acuity is decreased if the ulcer is located in the central visual axis
(c) Cornea reveals a round or irregular opacity or infiltrate – classically central in location
(d) Severe cases may have hypopyon (white, hazy base - due to WBC infiltration)
(e) Fluorescein reveals staining epithelial defect
1) Ciprofloxacin (Ciloxan) or Ofloxacin (Ocuflox) Ophthalmic drops
2) Fluroquinolone (Vigamox) Q1h.
