Ocular Trauma

Question 1

where are the majority of minor eye injuries taken place?

Answer 1

at work

Question 2

name the 3 mechanisms of injury

Answer 2

blunt trauma

penetrating trauma - small or large objects

burns - chemical or physical

Question 3

what drops are used to identify areas of epithelial loss?

Answer 3

fluorescein - blue but goes green in abrasion

Question 4

name the first 3 golden rules

Answer 4

1. history
2. record visual acuity
3. fluorescein

Question 5

in blunt trauma, name the 3 ways a force to the eye can move

Answer 5

up
down
forward

Question 6

which of up, down and forward in terms of force has least resistance?

Answer 6

down - blow out fracture

Question 7

on MRI of patient with a blow-out fracture, what sign is seen?

Answer 7

teardrop sign

Question 8

what can be a consequence of blow out fracture?

Answer 8

eye can no longer look up - teachers superior rectus muscle

Question 9

what is golden rule number 4?

Answer 9

handle suspected globe rupture with care

Question 10

blood cells in the inferior 1/3 of the anterior chamber of the eye is called what?

Answer 10

hyphaema

Question 11

what has to tear for a lens to detach?

Answer 11

zonules

Question 12

what does commotio retinae stand for?

Answer 12

bruised retina

Question 13

what is often mis-shapen in a corneal laceration?

Answer 13

the pupil

Question 14

what test do you perform to check if a penetrating injury has resulted in a leak?

Answer 14

SIDEIL test

Question 15

what is the management of a SIDEIL test positive case?

Answer 15

surgical repair

Question 16

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?

Answer 16

sympathetic ophthalmia

Question 17

name the antibiotic given patients with a corneal foreign body

Answer 17

chloranphenical

Question 18

when should suspect a penetrating foreign body?

Answer 18

irregular pupil

shallow anterior chamber

localised cataract

gross inflammation

Question 19

what does IOFB stand for?

Answer 19

intra-ocular foreign body

Question 20

what test should you perform in a potential IOFB

Answer 20

x-ray

Question 21

what is golden rule number 5?

Answer 21

X-Ray orbits if suspicion of Intra-Ocular Foreign Body (IOFB)

Question 22

which is worse, an acidic or alkali chemical burn of the eye?

Answer 22

alkali - easy and rapid penetration

acid - coagulates proteins and so little penetration

Question 23

what cells are important in the regeneration of the cornea?

Answer 23

limbus-limbo stem cells

Question 24

what does an alkali burn do to the eye?

Answer 24

ischaemia

Question 25

china white appearance of the sclera is seen in what?

Answer 25

limbal ischaemia

Question 26

what is the chemical injury management?

Answer 26

history
toxbase
pH
irrigate +++ 2l saline

THEN assess at slit lamp

Question 27

what is golden rule number 6?

Answer 27

Immediate irrigation of chemical injuries

the solution to pollution is dilution

Question 28

list the 6 golden rules of ocular trauma

Answer 28

1. History is key
2. Always record visual acuity
3. Don’t forget Fluorescein
4. Handle suspected globe rupture with care…
5. X-Ray orbits if suspicion of Intra-Ocular Foreign Body (IOFB)
6. Immediate irrigation of chemical injuries

(the solution to pollution is dilution)

Question 29

corneal scarring and vascularisation are seen in alkali burn of the eye

true or false?

Answer 29

true

Question 30

cataracts can only occur after months/years

true or false?

Answer 30

false - can happen in minutes with a penetrating foreign body