ocular trauma Flashcards
how is ocular trauma assessed?
- good history
- visual acuities
- examination of the eye (lids, conjunctiva, cornea, anterior segment, pupils, fundus)
- use fluorescein drops (to identify the area of epithelial loss)
what is visual acuity?
-the measure of the ability of the eye to distinguish shapes and the details of objects at a given distance
what are the golden rules for ocular trauma?
- history is key
- always record visual acuity
- fluorescein is your friend!
- handle global rupture with care
what is a blow out fracture?
-trauma to the eye can causes a break of one or more bones around the eyes
bones commonly broken:
- inferior blow out fracture
- nasally
what is the worry in a blow out fracture?
-eye nerve or muscle entrapment (THESE ARE EMERGENCIES)
what is this and what is the treatment?
- subconjubctival bleeding (haemorrhage)
- it is like a bruise, will settle over time
what is this?
-globe rupture (HANDLE WITH CARE)
what is this?
- traumatic uveitis
- caused by minor trauma (got hit by a ball in the face)
what is a hyphaema?
-blood in the anterior chamber of the eye (RED FLAG!)
what has happened here?
-dislocated lens (common in patients with Marfan’s)
what is this?
-retinal detachment
what is this?
-lid laceration
what is this?
-corneal laceration
what is this?
-corneal laceration
what is this?
-scleral laceration
what is sympathetic ophthalmia?
- penetrating injury to one eye, exposing intra ocular antigens and there is an auto immune reaction in both eyes
- causes inflammation in both eyes
- may lead to bilateral blindness (from a unilateral injury)
where are small objects most commonly lodged in the eye?
-externally in surface of cornea
what type of eye injury can u not repair?
-posterior eye injury
what does sub tarsal refer to?
-under the eye lid
what usually causes intra ocular foreign bodies?
-fast moving particles (e.g. hammer and chisel injuries)
what investigations should be done for intra ocular foreign bodies?
X ray or CT orbits if suspicion of intra ocular foreign body
what is used to test for burns?
-use pH paper
what does alkali burn cause?
- limbal ischaemia
- this can cause chronic problems of the cornea
what is a bad sign post alkali burn injury?
-a very white eye
what is the management for chemical injury?
what is the golden rule for chemical injuries?
-immediate irrigation of chemical injuries (the solution to pollution is dilution)
