Ocular trauma

Question 1

What are the three types of trauma that can occur to the eye/orbit?

Answer 1

Blunt force
Penetrating
Burns

Question 2

What kind of damage can blunt force trauma cause to the eye?

Answer 2

Blowout fracture
Scleral reddening
Hyphaema
Lens dislocation
Retinal detatchment

Question 3

What happens in a blowout fracture?

Answer 3

Increase pressure forces weakest part of orbit to break. Generally ethmoid orbital plate.

Question 4

What is a clear sign of a blowout fracture?

Answer 4

Tear drop sign

Question 5

What can a blowout fracture lead to?

Answer 5

IR tethering therefore cannot look up

Question 6

What causes scleral reddening?

Answer 6

Bleeding from blood vessels in sclera- basically a bruise/

Question 7

What is hyphaema?

Answer 7

Blood in anterior chamber

Question 8

How can hyphaema often be seen?

Answer 8

Level of settled RBC like hypopyon

Question 9

What are the two categories of penetrating trauma?

Answer 9

Large

Small

Question 10

What kind of injuries can large penetrating trauma cause?

Answer 10

Lid laceration
Corneal laceration
Scleral laceration

Question 11

What tends to cause lid laceration?

Answer 11

Dogs

Question 12

How can you see corneal laceration?

Answer 12

Pupil/iris prolapsing out. Seidel’s test

Question 13

How do you test for a corneal laceration?

Answer 13

Seidel’s test

Question 14

How do you perform a Seidel’s test?

Answer 14

Flood the eye with fluorescein so it won’t fluores then where aqueous humour leaks out it is diluted so glows green.

Question 15

What kind of damage can small penetrating trauma cause?

Answer 15

Subtarsal foreign body
Conjunctival foreign body
Corneal foreign body
Penetrating foreign body

Question 16

What is a subtarsal foreign body?

Answer 16

foreign body under the eyelid

Question 17

What is a conjunctival foreign body?

Answer 17

foreign body on the conjunctiva

Question 18

What is a corneal foreign body?

Answer 18

foreign body in the conjunctiva

Question 19

What is a penetrating foreign body?

Answer 19

foreign body that penetrates through cornea or sclera

Question 20

Where can a penetrating foreign body be located?

Answer 20

Anterior chamber
Intralenticular
Intraocular
Intraorbital

Question 21

When should you suspect a penetrating foreign body?

Answer 21

Pupil irregularity
Localised cataracts
Gross inflammation

Question 22

What two types of burns can occur?

Answer 22

Chemical

Physical

Question 23

What two types of substances can cause chemical burns?

Answer 23

Acid

Alkali

Question 24

Is acid or alkali worse to be burned by?

Answer 24

Alkali

Question 25

What kind of damage does acid do?

Answer 25

Superficial

Question 26

What kind of damage does alkali do?

Answer 26

Deep penetration and lots of scarring

Question 27

How do you treat a chemical burn?

Answer 27

Irrigation (The Solution to Pollution is Dilution)

Question 28

How do you process an eye trauma case?

Answer 28

Detailed history
Visual acuity- always do!!!
Eye examination- Front to back

Question 29

What are the 6 golden rules of eye trauma?

Answer 29

Good history
Record visual acuity
Fluorescein
Handle suspected globe ruptures with care
X-ray suspected IOBF
Immediately irrigate chemical burns