Ocular Trauma

Question 1

What part of the orbit has been compromised here?

What injury causes this to happen?

What type of trauma causes this injury?

Answer 1

Inferior wall of the orbit

Orbital blow out fractures

Blunt trauma

Question 2

A certain muscle commonly gets tethered in orbital blow out fractures. What muscle is this?

Answer 2

Inferior Rectus

Question 3

This is a common presentation of blunt trauma. What is it?

If this occurs without any history of trauma, what should always be checked?

Answer 3

Subconjunctival haemorrhage

Always check BP

Question 4

What injury would you be worried about with this severe subconjunctival haemorrhage?

Answer 4

Globe rupture

Question 5

What is the most common form of traumatic uveitis?

Answer 5

Anterior uveitis

Question 6

What is this clinical sign?

What is it a sign of?

Answer 6

Hyphaemia- blood in the anterior chamber

Significant intra-ocular trauma

Question 7

What does this show?

Who does it occur spontaneously in?

What causes this to occur as a result of trauma?

Answer 7

Retinal detachment

Occurs spontaneously in short-sighted people mostly

Fluid under the retina in trauma causes it to detach

Question 8

What does this show?

Answer 8

Choroidal tear

Question 9

What does this show?

What area is usually affected?

Is this symptomatic?

What happens if this occurs in the middle area?

Answer 9

Bruised retina

The peripheries are usually affected

Usually asymptomatic

Vision may never resolve to what it originally was

Question 10

Explain what happens in sympathetic ophthalmia?

Answer 10

There is penetrating injury to one eye. This exposes both eyes to intra-ocualr antigens and an autoimmune reaction takes place in both eyes which leads to inflammation and possible bilateral blindness.

Question 11

Foreign bodies found where are most likely to cause visual changes?

Answer 11

Intra-ocular and intra-orbital

Question 12

Where is this foreign body?

Answer 12

Sub-tarsal

Question 13

Where is this foreign body?

Answer 13

Conjunctiva

Question 14

Where is this foreign body?

Answer 14

Cornea

Question 15

What is the treatment following a foreign body in the eye?

Answer 15

Chloramphenicol ointment 4x daily for around a week

Question 16

Some foreign bodies can be penetrating. When should you be more suspicious of these?

Answer 16

The pupil is irregular

Anterior chamber is shallow

Localised cataract

Gross inflammation

Question 17

Intra-ocular foreign bodies should always be given what investigation?

Answer 17

X-ray

Question 18

This is an acid burn. What do these do?

Answer 18

Coagulate proteins and cause little penetration

Question 19

What do alkali burns cause?

Answer 19

Easy, rapid penetration

Cicatrising changes to the conjunctiva and cornea

Penetrates the intra-ocular structures

Question 20

This is an alkali burn. Why is the new ischaemia worrying?

Answer 20

Ischaemia can affect the limbus which is where corneal stem cells are found- damage here would mean the cornea would not heal and there would be scarring

Question 21

What does this picture show?

Answer 21

Limbal ischaemia

Question 22

Why should you be aware of chemical burns with lime or cement?

Answer 22

They are very small particles which can get trapped

Question 23

How long should you irrigate chemical burns for?

Answer 23

At least 2l of saline or until pH returns to normal