ocular trauma Flashcards
true emergencies (2)
- chemical burns
2. CRAO
initial tx of chemical burns (3)
- topical anesthetic
- check for foreign bodies
- copious irrigation
tx of chemical burns after irrigation (4)
- cycloplegic agent
- topical Abx
- pressure patch
- refer
foreign body sensation, INTENSE pain, tearing, photophobia
corneal abrasion
what is the drug of choice for tx of corneal abrasion?
ketorolac
when to f/u for corneal abrasion
24 hrs
who should you not patch (3)
- contact lens wearers
- dendritic or stellate epithelial defects
- poor historians
hyphema management
assume globe is ruptured, shield, refer
what sort of prophylaxis to give if globe is ruptured
tetanus
possible risk assoc with severe orbital hemorrhage
blindness
tx of severe orbital hemorrhage
emergent lateral cathotomy
periorbital edema, ecchymosis, diplopia, subcut emphysema
orbital fracture
surgical indications for orbital fracture (2)
- persistent diplopia
2. enophthalmos
welder’s burn, snow blindness
UV keratitis
photophobia, foreign body sensation, tearing, pain, 24 hrs after exposure to UV
UV keratitis
looks ominous generally harmless
conjunctival hemorrhage
elevated ESR, elevated CRP, incr platelet count
temporal arteritis
laceration of ocular nerve, intraorbital hemorrhage
direct traumatic optic neuropathy
shear forces on nerve of vascular supply
indirect traumatic optic neuropathy
visual loss if severe and rapid; RAPD+
traumatic optic neuropathy
Sudden painless visual loss; RAPD+; cherry red spot
CRAO
elevated ESR, elevated CRP, incr platelets
temporal arteritis
if get elevated ESR, elevated CRP, incr platelets, then how to tx?
start high dose systemic steroids, do temporal artery biopsy
