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Ophthalmology > Ocular Trauma > Flashcards

Ocular Trauma Flashcards

1
Q

Corneal Abrasions

A

Maybe patch?
Oral Pain meds
Prophylactic Abx
Check back in 24 hrs

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2
Q

Conjunctival Laceration

A
  • May be isolated or part of other injuries.
  • Ocular irritation, pain, foreign body sensation
  • Chemosis, subC hemorrhage, torn conjunctiva
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3
Q

Conjunctival Lac Mgmt

A

Observation
Prophylactic topical Abx
Surgical repair for large lacerations

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4
Q

Corneal Lacerations

A
  • If lac is through all layers of the cornea, it is an open globe injury.
  • Cover eye with shield or cup
  • NO pressure on eye
  • Analgesics
  • Lower IOP
  • Td
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5
Q

Lid Lacerations

A

A laceration of the eyelid
Require eval for open globe injury
Look out for orbital fat prolapse

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6
Q

Full thickness lid laceration = ?

A

Immediate Ophtho consult

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7
Q

Foreign Body

A

Can remove with slit lamp and 18G needle
Rust ring will form within a day
Make sure no intraocular FB is present

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8
Q

Metal is toxic to ______?

A

Photoreceptors. Can destroy retinal cells.

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9
Q

Penetrating Trauma

A 
Emergency Department Mgmt
Eye shield
NPO, optho referral
IV cephalosporin
CT, radiographs
DO NOT measure IOP
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10
Q

Intraocular FB

A

Metal on metal
Deep eye pain
Use CT scan

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11
Q

Hey pat, is an MRI a good method to detect an intraocular foreign body in a metalworker?

A

No, it will rip their eyes out and kill everyone in the whole world. This includes everyone you love, have ever loved and ever will love. All of the fluffy kittens and puppies and unicorns will also perish. Do not give this person an MRI.

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12
Q

Globe Rupture

A

A very serious situation where the outer integrity of the eye os disrupted by blunt or penetrating trauma.

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13
Q

Globe rupture mgmt

A 
CT scan to RO entrapment
NPO
Td status
Emergent consult
IV analgesics, abx
Treat N/V aggressively
elevate head of bed
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14
Q

Orbital Wall Fx

A
  • Blowout Fracture
  • Orbital walls are thin and tend to fracture with blunt trauma.
  • Common areas are medial wall and floor
  • May entrap fat and muscles
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15
Q

Blowout Fx Eval

A 
Visual Acuity, color testing
EOM check
Check for proptosis or ENopthalmos
Palpate for step offs and crepitous
Check facial sensation
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16
Q

Blowout Fx mgmt

A

CT scan
Refer to surgery
Abx (keflex, augmentin)

17
Q

UV/Photokeratitis

A

Caused by UV radiation to the eyes
Recreational sun exposure
Sunlamps, tanning beds
Anything with UV radiation

18
Q

UV keratitis Presentation

A

Photophobia, FB sensation, usually bilateral
Erythema of face and lids, decreased VA
NO discharge, hazy cornea, constricted pupils
VERY painful

19
Q

UV keratitis Tx

A

Oral analgesics
Lubricating abx ointment
recheck in 1-2 days

20
Q

Hyphema

A

Blood in the anterior chamber
Medical emergency
Check VA
Can result in permanent vision loss

21
Q

Hyphema Emergency Mgmt

A

Assess primary injury
Manage IOP increases
Immediate referral

22
Q

Hyphema Tx

A

Elevate head
Dilate pupil, eye patch
Control IOP (Timoptic, diamox)
IV mannitol

23
Q

Which X-ray view should be obtained for a suspected blowout fx?

A

Waters View.

24
Q

When should a hyphema be admitted (3 factors)?

A
  • Anti-coagulated
  • Decreased VA
  • ED eval is greater than 1 day after injury
25
Q

Is an alkali or acid burn generally worse?

A

Alkali is generally worse.

26
Q

Chemical Burn

A

Requires immediate treatment
Copious irrigation
Assess ocular damage and manage accordingly

27
Q

Continuous eye irrigation should be done for chemical burns until pH reaches ?

A

7.5 range.

28
Q

Post-irrigation mgmt of chemical burns

A

Erythromycin
Cycloplegic if epithelial defect (cyclopentolate)
Optional eye patch if unilateral
Prompt optho consult

29
Q

Traumatic Iritis

A 
Inflammation of the iris (cell and flare)
Moderate blunt injury
Pain, blurred vision, HA, photophobia
Lid bruising/edema
Sluggish pupil
Optho consult!
30
Q

Traumatic Iritis Tx

A

Usually resolves within a week

  • Topical steroid
  • Cycloplegic (cyclogyl) several times/day
31
Q

Retrobulbar Hemorrhage

A
  • Disruption and hemorrhage or posterior arterial supply.
  • Trauma, surgery, infxn
  • 24 hrs post-trauma
32
Q

Retrobulbar Hemorrhage Presentation

A

Malposition of the eye
Increased IOP
Proptosis
Refer!

33
Q

Preorbital (preseptal) cellulitis

A

Infxn of soft tissues anterior to orbit septum

Mild: rarely has complications

34
Q

Orbital Cellulitis

A

Infection of the contents of the orbit (fat and muscles).

May cause loss of vision and fatality

35
Q

Preorbital Cellulitis Tx

A

Consult optho and ENT
Outpatient if greater than a year old
Oral Abx (clindamycin or bactrim AND augmentil

36
Q

Orbital Cellulitis Tx

A 
Inpatient admission
IV Abx (Vanco and Ampicillin) for 2-3 weeks

Ophthalmology (12 decks)

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