Ocular Emergencies -- SD Flashcards
Small vessel rupture that causes bleeding under the conjunctiva
Subconjunctival hemorrhage
Are subconjunctival hemorrhages painful?
No
Is the eyelid or iris affected with a subconjunctival hemorrhage?
No
How do we treat subconjunctival hemorrhages?
We don’t – resolves on their own
Patient presents with a foreign body sensation when blinking, what is it?
Corneal abrasion
How do we treat a corneal abrasion?
Remove any foreign body, irrigate eye if indicated, abx ointment, and pain medications.
Can a patient with a corneal abrasion wear their contacts?
no
Patient comes in and says it hurts to blink and they can point to a pinpoint area of pain – Dx?
Corneal foreign body
What are some foreign body removal techniques?
Cotton tip applicator, 18 gauge needle, alger brush
Blood in the anterior champber
Hyphema
What is a hyphema caused by?
iris root vessel ruptures
Is a hyphema typically caused by a traumatic injury?
yes
How do we treat a hyphema?
Elevate head of bed to allow blood to settle
measure and control IOP
IOP greater than ____ is concerning
20
Tetracaine helps superficial for deep eye pain?
Superficial only! this can help you decipher between surface problems or deeper eye problems
Iris protruding through globe
Ruptured globe
What do we do when evaluating a hyphema that we do NOT use when evaluating a ruptured goal.
Measure IOP – do NOT measure IOP with a ruptured globe
How to chemical burns typically present?
Similar to corneal abrasions – typically 6-12 hours after the incident
What is the vital sign for the eye?
Visual acuity
What are the take home points of ocular emergencies?
- Constant vigilance for signs of rupture globe and/or deep eye injury
- Watch for entrapment with blunt trauma
- Visual acuity is the vital signs for the eye
- Be comfortable with all parts of the eye exam
How do we diagnose a chemical burn?
You will see superficial punctate keratitis on fluorescein dye exam with slit lamp
What is the cause of acute angle-closure glaucoma?
elevated IOP
How do we treat acute angle-closure glaucoma?
Rapid IOP reduction!!
Can we restore vision loss lost from acute angle-closure glaucoma?
Nope
what is the most common cause of blindness in the western world?
Herpes simplex keratitis
Antivirals or steroids to treat herpes simplex keratitis?
Antivirals, NO STEROIDS
