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ER Part 2 > OCULAR EMERGENCIES > Flashcards

OCULAR EMERGENCIES Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

What should you always document with and eye complain?

A

That you everted the lid

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2
Q

What must you ALWAYS know with an eye complaint?

A

Visual acuity!

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3
Q

What are some special tests we should do for eye exams?

A

Woods lamp, slit lamp, and IOP

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4
Q

What is this?

A

Subconjunctival hemorrhage

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5
Q

Should there be anything wrong with the eyelid, iris, vision or pain with subconjunctival hemorrhage?

A

Nope

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6
Q

How does someone acquire a subconjunctival hemorrhage?

A

Trauma, Valsalva, or spontaneous

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7
Q

How long will SH last?

A

1-2 weeks

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8
Q

What is this?

A

Corneal abrasion

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9
Q

A patient presents with what feels like sand in their eye – diagnosis?

A

Corneal abrasion

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10
Q

What types of questions should we ask with a corneal abrasion?

A

Contact lenses! (they can’t wear them)

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11
Q

What should you do to have a better exam of a corneal abrasion?

A

TOPICAL anesthesia → burns like hell for 10 seconds and then it’s numb And IT IS NOT SAFE TO USE MORE THAN TWICE!! THEY CAN BURN A HOLE IN THEIR EYE… aka don’t send them home with it

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12
Q

What must you complete with PE of a corneal abrasion?

A

Lid eversion, dye, magnification, and woods lamp/slit lamp

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13
Q

How do you treat a corneal abrasion?

A

Remove any FB, irrigate the eye, Abx ointment F/U with ophthalmologist

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14
Q

If a patient has pain with blinking and they point to a pinpoint area of pain – diagnosis?

A

Conjunctival FB or the corneal abrasion

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15
Q

What are some removal techniques for a conjunctival FB?

A

Cotton tip applicator, 18g needle, and alger brush

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16
Q

If ____ is present in the eye, try burring away superficial areas, before sending optho f/u

A

Rust Remember any metal will rust

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17
Q

If there is a full thickness FB or rust in the eye (especially if over the pupil) – what should you not do?

A

Do NOT attempt to remove!!

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18
Q

In any trauma to the eye, what must you rule out?

A

Ruptured globe

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19
Q

How do you rule out a ruptured globe?

A

Flatness of the anterior chamber Hyphema (significant ocular trauma) Extra-ocular movements

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20
Q

With a blunt trauma of the eye what else must you evaluate on PE?

A

Orbital and maxillofacial exam

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21
Q

What is this?

A

Hyphema

22
Q

What is a hyphema?

A

blood in the anterior chamber

23
Q

A patient comes in on a stretcher after blunt trauma to the face, what must you do?

A

SIT THEM UP!!!

24
Q

How do you treat hyphema?

A

Elevate the head of the bed to allow blood to settle. Measure and control IOP (assume deep ocular injury) Optho consult

25
Q

What is considered a high intra-ocular pressure?

A

Greater than 20

26
Q

What is a blunt trauma to the orbit?

A

Blowout fracture

27
Q

What diagnostics should you get for a blowout fracture?

A

CT! for orbit/facial bone fractures

28
Q

Any significant penetrating/blunt trauma the first thing to rule out is what?

A

Ruptured globe **True optho emergency!!!

29
Q

What is this?

A

Ruptured globe

30
Q

What will you see on examination with a ruptured globe?

A

Hyphema, intra ocular fb, and irregular pupil

31
Q

What do you do/not do for a ruptured globe?

A

STAT optho consult DO NOT measure IOP IV cephalosporins

32
Q

What eye injury results from “peeking” (welding and peek from behind the mask) but presents similar to corneal abrasions?

A

A: Flash burn (from the intensity of light)

33
Q

How do you diagnose a flash burn?

A

Superficial punctate keratitis on fluorescein dye → exam with slit lamp

34
Q

How do you treat a flash burn?

A

E-mycin, pain meds, cycloplegics, and e-mycin

35
Q

What are some take home points with traumatic eye injuries?

A

Constant vigilance for signs of ruptured globe and/or deep eye injury Watch for entrapment with blunt trauma Visual acuity is the vital sign for the eye Be comfortable with all parts of the eye exam

36
Q

Patient comes in complaining of itchy, inability to open their eye in the AM with crusting – diagnosis?

A

Conjunctivitis

37
Q

How does conjunctivitis move?

A

:Starts unilateral → Will become bilateral

38
Q

Is the majority of conjunctivitis viral or bacterial?

A

Viral

39
Q

How do you treat conjunctivitis?

A

Often Abx

40
Q

What’s do we have to worry about in a newborn with conjunctivitis?

A

Often gonorrhea → MUST treat

41
Q

A patient presents with pain in the eye with no trauma what should you think of?

A

Acute glaucoma and Herpes Keratitis

42
Q

What should you do for EVERY patient with an eye problem?

A

Fluorescein dye with DOCUMENTATION that no herpetic lesion seen!!

43
Q

What is the most common source of blindness in the western world?

A

Herpes keratitis

44
Q

How do you diagnose herpes keratitis? How do you treat it?

A

Dx = fluorescein exam Tx = antivirals, NO STEROIDS (they will go blind!), mandatory optho consult!!!

45
Q

An eye that HURTS with no trauma is what, until proven otherwise?

A

Acute glaucoma →

46
Q

: A patient presents with eye pain, blurred vision, N/V/HA, and a steamy pupil – diagnosis?

A

Acute glaucoma (must have 2 of those symptoms)

47
Q

What 3 things must you see on PE to diagnose acute glaucoma?

A

IOP greater than 21mmHg Conjunctival injection And mid-dilated nonreactive pupil

48
Q

: How do you treat acute angle glaucoma?

A

Optho emergency!!! They will go blind if not treated quickly!!

49
Q

What are some take home point of medical eye points?

A

Red, painful eye = ocular emergencies if non-traumatic until proven otherwise Not all conjunctival issues are benign If in doubt, consult optho

50
Q

What is the order you should always go when looking at eyes?

A

Eyelids Sclera Hyphema Pupil

ER Part 2 (7 decks)

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