Ocular Trauma Flashcards
Onset of FB trauma
Sudden
Sx FB trauma
Irritation + photophobia
Maybe decreased vision
Where do FB commonly get stuck?
Under eyelid
If you think there is a possible penetrating injury with a FB, what should you do?
XRAY/CT/US
What kind of objects are there a higher risk of infection in a FB ocular trauma?
Organic
Stones
Mx FB ocular trauma
Prompt removal + LA
+ chloramphenicol drops (prevent infection)
Consider cycloplegic
What causes corneal abrasion?
Finger nail/scratching objects
Sx corneal abrasion
Pain
Watering
Photophobia
What infection risk is there is corneal abrasion?
Keratitis
How are the defects stained in corneal abrasino?
Fluorescein
Mx corneal abrasion
Refer if large LA Chloramphenicol 7 days Analgesia Avoid contact lenses Re-examine in 24hrs
When should you refer a corneal abrasion?
If large abrasion
If hasn’t completely healed after 48hrs or worsening Sx
What sort of a Hx would lead you to suspect a penetrating injury?
Works w/ tools/metals
Signs of full thickness penetration (6)
Distorted edge Subconjunctival haemorrhage Distorted pupil/iris Iris prolapse Hyphaema Seidel's sign
What is a hyphaema?
Blood in the anterior chamber
What is Seidel’s sign
Clear streeak of aq in fluorescein stained area
Mx Penetrating injury
Don’t touch/manipulate
Immediate surgery req
What infection is there a risk of w/ penetrating injury
Endophthalmitis
Are acid or alkali chemical injury more serious? Why?
Alkali
Acid coag protein + show slower penetration
Signs chemical injury (5)
Redness Pain Blurring Photophobia Cloudy cornea
1st step Mx chemical injury
Irrigate eyes IMMEDIATELY
H20/saline
before you examine
How to check pH after chem injury
Litmus paper
Check both eyes for comparison
Complications chemical injury (3)
Corneal scarring
Opacification
Lid damage
What is Iridodialysis
Iris detachment from base –> D shaped pupil
What happens during orbital fracture
Blow out fracture common
Globe forced backwards, fracture of orbital floor
Herniation of orbital contents into maxillary sinus
What happens when infra-orbital nn injury occurs
Loss of sensation on lower eyelid + cheek
Signs of retrobulbar haemorrhage (5)
Severe pain
Progressive visual loss + ophthalmoplegia
Proptosis
RAPD
Posterior edge of haemorrhage not visible
Mx retrobulbar surgery
Immediate surgery
