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Ophthalmology > Ocular Trauma > Flashcards

Ocular Trauma Flashcards

1
Q

What are the leading mechanisms of trauma to the eye?

A

Blunt trauma (41%) and penetrating injury without a foreign body (37%)

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2
Q

What is the most common age group affected by ocular trauma?

A

Age 25-34

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3
Q

How are males affected my ocular trauma?

A

Usually between the ages of 25-34, often related to assault or machinery

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4
Q

How are females affected by ocular trauma?

A

Usually aged >60, related to falling at home

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5
Q

What types of injuries are associated with poor outcomes?

A

Injuries that occur at home or in a public place and injuries caused by a fall or assault

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6
Q

What are the mechanisms by which ocular trauma can occur?

A

Blunt trauma, penetrating trauma (large/small), burns (chemical/physical)

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7
Q

What are the golden rules when assessing a patient with ocular trauma?

A

History is key, always record visual acuity, don’t forget fluorescein

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8
Q

What should areas be covered under your examination?

A

Lids, conjunctiva, cornea, anterior segment, pupils, fundus

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9
Q

What are fluorescein drops used for?

A

To identify areas of epithelial loss

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10
Q

What kind of fracture may occur due to blunt trauma?

A

Blowout fracture = fracture to one or more of the orbital walls but the orbital rim remains intact

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11
Q

What is the normal mechanism of injury of a blowout fracture?

A

Direct blow to central orbit, usually with a ball etc

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12
Q

What are some signs of a blowout fracture?

A

Tenderness and swelling around the eye, double vision (diplopia), nosebleeds

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13
Q

What part of the eye may be ruptured by blunt trauma?

A

The globe = must be handled with care

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14
Q

What are some features of traumatic uveitis that occurs following blunt trauma?

A

May be 2-3 days after initial insult before symptoms appear = eye pain, redness, blurred vision, tearing

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15
Q

What is hyphaema?

A

Blood in the anterior chamber = may be caused by blunt trauma

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16
Q

What are some injuries that may occur due to blunt trauma?

A

Tearing on intra-ocular structures, dislocated lens, retinal detachment, choroidal tear, optic nerve avulsion, severe intra-ocular disruption

17
Q

What is commotio retinae?

A

Bruised retina = may be caused by blunt trauma

18
Q

What may penetrating trauma by a large object cause?

A

Laceration, leak of fluid from eye, sympathetic ophthalmia

19
Q

What are some areas of the eye that may be lacerated by a large object in penetrating trauma?

A

Lid, cornea, sclera

20
Q

What are some features of penetrating trauma to the eye with fishhooks?

A

May involve all structures of the eye = associated with traumatic cataract, vitreous/choroidal haemorrhage and retinal detachment

21
Q

What causes sympathetic ophthalmia?

A

Penetrating injury to one eye = causes exposure of intra-ocular antigens leading to auto-immune reaction in both eyes

22
Q

What may sympathetic ophthalmia lead to?

A

Bilateral inflammation and eventual blindness

23
Q

What are the different classes of small particles that may cause penetrating trauma to the eye?

A

Sub-tarsal, conjunctival, corneal, intra-ocular, intra-orbital

24
Q

How are small particles removed from the eye?

A

Slit lamp used, local anaesthetic, edge of needle used to scrape/scoop, cover with chloramphenicol ointment after

25
Q

What may be some features of penetrating trauma due to small particles?

A

Irregular pupil, shallow anterior chamber, localised cataract, gross inflammation

26
Q

What should be done if there is suspicion of intra-ocular foreign bodies (IOFB)?

A

X-ray of the orbit

27
Q

What do intra-ocular foreign bodies tend to be?

A

Fast moving particles (e.g from hammer/chisel injuries)

28
Q

What are some features of alkali burns?

A

Easy and rapid penetration, cicatrising changes to conjunctiva and cornea, penetrates the intra-ocular structures

29
Q

What are some features of acid burns?

A

Little penetration, coagulates proteins

30
Q

What may chemical burns cause?

A

Ischaemia and scarring

31
Q

What is the essential treatment for all chemical burns?

A

Immediate irrigation

32
Q

What are the features of the assessment of a patient with chemical burns?

A

Occurs after thorough irrigation = history (nature of chemical, when etc), check toxobase and pH, irrigate until pH normal then assess at slit lamp

33
Q

What chemicals should you be extra careful of?

A

Lime and cement

34
Q

What is Siedel’s test used for?

A

Determining whether there is a corneal perforation

Ophthalmology (20 decks)

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