Ocular Trauma Flashcards
where are the majority of minor eye injuries taken place?
at work
name the 3 mechanisms of injury
blunt trauma
penetrating trauma - small or large objects
burns - chemical or physical
what drops are used to identify areas of epithelial loss?
fluorescein - blue but goes green in abrasion
name the first 3 golden rules
- history
- record visual acuity
- fluorescein
in blunt trauma, name the 3 ways a force to the eye can move
up
down
forward
which of up, down and forward in terms of force has least resistance?
down - blow out fracture
on MRI of patient with a blow-out fracture, what sign is seen?
teardrop sign
what can be a consequence of blow out fracture?
eye can no longer look up - teachers superior rectus muscle
what is golden rule number 4?
handle suspected globe rupture with care
blood cells in the inferior 1/3 of the anterior chamber of the eye is called what?
hyphaema
what has to tear for a lens to detach?
zonules
what does commotio retinae stand for?
bruised retina
what is often mis-shapen in a corneal laceration?
the pupil
what test do you perform to check if a penetrating injury has resulted in a leak?
SIDEIL test
what is the management of a SIDEIL test positive case?
surgical repair
Penetrating injury to one eye
exposure of intra-ocular antigens causing auto-immune reaction in both eyes
Inflammation in both eyes
May lead to bilateral blindness (from a unilateral injury)
Extremely rare - but is very important and must always be remembered
diagnosis?
sympathetic ophthalmia
name the antibiotic given patients with a corneal foreign body
chloranphenical
when should suspect a penetrating foreign body?
irregular pupil
shallow anterior chamber
localised cataract
gross inflammation
what does IOFB stand for?
intra-ocular foreign body
what test should you perform in a potential IOFB
x-ray
what is golden rule number 5?
X-Ray orbits if suspicion of Intra-Ocular Foreign Body (IOFB)
which is worse, an acidic or alkali chemical burn of the eye?
alkali - easy and rapid penetration
acid - coagulates proteins and so little penetration
what cells are important in the regeneration of the cornea?
limbus-limbo stem cells
what does an alkali burn do to the eye?
ischaemia
china white appearance of the sclera is seen in what?
limbal ischaemia
what is the chemical injury management?
history
toxbase
pH
irrigate +++ 2l saline
THEN assess at slit lamp
what is golden rule number 6?
Immediate irrigation of chemical injuries
the solution to pollution is dilution
list the 6 golden rules of ocular trauma
- History is key
- Always record visual acuity
- Don’t forget Fluorescein
- Handle suspected globe rupture with care…
- X-Ray orbits if suspicion of Intra-Ocular Foreign Body (IOFB)
- Immediate irrigation of chemical injuries
(the solution to pollution is dilution)
corneal scarring and vascularisation are seen in alkali burn of the eye
true or false?
true
cataracts can only occur after months/years
true or false?
false - can happen in minutes with a penetrating foreign body
