ocular trauma

Question 1

how is ocular trauma assessed?

Answer 1

• 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)

Question 2

what is visual acuity?

Answer 2

-the measure of the ability of the eye to distinguish shapes and the details of objects at a given distance

Question 3

what are the golden rules for ocular trauma?

Answer 3

• history is key
• always record visual acuity
• fluorescein is your friend!
• handle global rupture with care

Question 4

what is a blow out fracture?

Answer 4

-trauma to the eye can causes a break of one or more bones around the eyes

bones commonly broken:

• inferior blow out fracture
• nasally

Question 5

what is the worry in a blow out fracture?

Answer 5

-eye nerve or muscle entrapment (THESE ARE EMERGENCIES)

Question 6

what is this and what is the treatment?

Answer 6

• subconjubctival bleeding (haemorrhage)

- it is like a bruise, will settle over time

Question 7

what is this?

Answer 7

-globe rupture (HANDLE WITH CARE)

Question 8

what is this?

Answer 8

• traumatic uveitis

- caused by minor trauma (got hit by a ball in the face)

Question 9

what is a hyphaema?

Answer 9

-blood in the anterior chamber of the eye (RED FLAG!)

Question 10

what has happened here?

Answer 10

-dislocated lens (common in patients with Marfan’s)

Question 11

what is this?

Answer 11

-retinal detachment

Question 12

what is this?

Answer 12

-lid laceration

Question 13

what is this?

Answer 13

-corneal laceration

Question 14

what is this?

Answer 14

-corneal laceration

Question 15

what is this?

Answer 15

-scleral laceration

Question 16

what is sympathetic ophthalmia?

Answer 16

• 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)

Question 17

where are small objects most commonly lodged in the eye?

Answer 17

-externally in surface of cornea

Question 18

what type of eye injury can u not repair?

Answer 18

-posterior eye injury

Question 19

what does sub tarsal refer to?

Answer 19

-under the eye lid

Question 20

what usually causes intra ocular foreign bodies?

Answer 20

-fast moving particles (e.g. hammer and chisel injuries)

Question 21

what investigations should be done for intra ocular foreign bodies?

Answer 21

X ray or CT orbits if suspicion of intra ocular foreign body

Question 22

what is used to test for burns?

Answer 22

-use pH paper

Question 23

what does alkali burn cause?

Answer 23

• limbal ischaemia

- this can cause chronic problems of the cornea

Question 24

what is a bad sign post alkali burn injury?

Answer 24

-a very white eye

Question 25

what is the management for chemical injury?

Answer 25

Question 26

what is the golden rule for chemical injuries?

Answer 26

-immediate irrigation of chemical injuries (the solution to pollution is dilution)