ocular trauma

Question 1

true emergencies (2)

Answer 1

1. chemical burns

2. CRAO

Question 2

initial tx of chemical burns (3)

Answer 2

1. topical anesthetic
2. check for foreign bodies
3. copious irrigation

Question 3

tx of chemical burns after irrigation (4)

Answer 3

1. cycloplegic agent
2. topical Abx
3. pressure patch
4. refer

Question 4

foreign body sensation, INTENSE pain, tearing, photophobia

Answer 4

corneal abrasion

Question 5

what is the drug of choice for tx of corneal abrasion?

Answer 5

ketorolac

Question 6

when to f/u for corneal abrasion

Answer 6

24 hrs

Question 7

who should you not patch (3)

Answer 7

1. contact lens wearers
2. dendritic or stellate epithelial defects
3. poor historians

Question 8

hyphema management

Answer 8

assume globe is ruptured, shield, refer

Question 9

what sort of prophylaxis to give if globe is ruptured

Answer 9

tetanus

Question 10

possible risk assoc with severe orbital hemorrhage

Answer 10

blindness

Question 11

tx of severe orbital hemorrhage

Answer 11

emergent lateral cathotomy

Question 12

periorbital edema, ecchymosis, diplopia, subcut emphysema

Answer 12

orbital fracture

Question 13

surgical indications for orbital fracture (2)

Answer 13

1. persistent diplopia

2. enophthalmos

Question 14

welder’s burn, snow blindness

Answer 14

UV keratitis

Question 15

photophobia, foreign body sensation, tearing, pain, 24 hrs after exposure to UV

Answer 15

UV keratitis

Question 16

looks ominous generally harmless

Answer 16

conjunctival hemorrhage

Question 17

elevated ESR, elevated CRP, incr platelet count

Answer 17

temporal arteritis

Question 18

laceration of ocular nerve, intraorbital hemorrhage

Answer 18

direct traumatic optic neuropathy

Question 19

shear forces on nerve of vascular supply

Answer 19

indirect traumatic optic neuropathy

Question 20

visual loss if severe and rapid; RAPD+

Answer 20

traumatic optic neuropathy

Question 21

Sudden painless visual loss; RAPD+; cherry red spot

Answer 21

CRAO

Question 22

elevated ESR, elevated CRP, incr platelets

Answer 22

temporal arteritis

Question 23

if get elevated ESR, elevated CRP, incr platelets, then how to tx?

Answer 23

start high dose systemic steroids, do temporal artery biopsy