Ocular Emergencies -- SD

Question 1

Small vessel rupture that causes bleeding under the conjunctiva

Answer 1

Subconjunctival hemorrhage

Question 2

Are subconjunctival hemorrhages painful?

Answer 2

No

Question 3

Is the eyelid or iris affected with a subconjunctival hemorrhage?

Answer 3

No

Question 4

How do we treat subconjunctival hemorrhages?

Answer 4

We don’t – resolves on their own

Question 5

Patient presents with a foreign body sensation when blinking, what is it?

Answer 5

Corneal abrasion

Question 6

How do we treat a corneal abrasion?

Answer 6

Remove any foreign body, irrigate eye if indicated, abx ointment, and pain medications.

Question 7

Can a patient with a corneal abrasion wear their contacts?

Answer 7

no

Question 8

Patient comes in and says it hurts to blink and they can point to a pinpoint area of pain – Dx?

Answer 8

Corneal foreign body

Question 9

What are some foreign body removal techniques?

Answer 9

Cotton tip applicator, 18 gauge needle, alger brush

Question 10

Blood in the anterior champber

Answer 10

Hyphema

Question 11

What is a hyphema caused by?

Answer 11

iris root vessel ruptures

Question 12

Is a hyphema typically caused by a traumatic injury?

Answer 12

yes

Question 13

How do we treat a hyphema?

Answer 13

Elevate head of bed to allow blood to settle

measure and control IOP

Question 14

IOP greater than ____ is concerning

Answer 14

20

Question 15

Tetracaine helps superficial for deep eye pain?

Answer 15

Superficial only! this can help you decipher between surface problems or deeper eye problems

Question 16

Iris protruding through globe

Answer 16

Ruptured globe

Question 17

What do we do when evaluating a hyphema that we do NOT use when evaluating a ruptured goal.

Answer 17

Measure IOP – do NOT measure IOP with a ruptured globe

Question 18

How to chemical burns typically present?

Answer 18

Similar to corneal abrasions – typically 6-12 hours after the incident

Question 19

What is the vital sign for the eye?

Answer 19

Visual acuity

Question 20

What are the take home points of ocular emergencies?

Answer 20

1. Constant vigilance for signs of rupture globe and/or deep eye injury
2. Watch for entrapment with blunt trauma
3. Visual acuity is the vital signs for the eye
4. Be comfortable with all parts of the eye exam

Question 21

How do we diagnose a chemical burn?

Answer 21

You will see superficial punctate keratitis on fluorescein dye exam with slit lamp

Question 22

What is the cause of acute angle-closure glaucoma?

Answer 22

elevated IOP

Question 23

How do we treat acute angle-closure glaucoma?

Answer 23

Rapid IOP reduction!!

Question 24

Can we restore vision loss lost from acute angle-closure glaucoma?

Answer 24

Nope

Question 25

what is the most common cause of blindness in the western world?

Answer 25

Herpes simplex keratitis

Question 26

Antivirals or steroids to treat herpes simplex keratitis?

Answer 26

Antivirals, NO STEROIDS