Ocular Trauma

Question 1

What are the three main types of ocular injury?

Answer 1

Penetrating injury
Blunt trauma
Burns (chemical or physical)

Question 2

What is a blowout fracture?

Answer 2

Fracture of the floor of the orbit

Question 3

What is the main concern with a blowout fracture?

Answer 3

Structures such as the inferior rectus may become trapped in the fracture

Question 4

How should you manage a foreign body in the anterior eye?

Answer 4

Remove:

• slit lamp
• local anaesthetic
• use the edge of a needle to scrape or scoop
• then cover with chloramphenicol ointment

Question 5

What should you do if you suspect an intra ocular foreign body?

Answer 5

Xray

Question 6

How is a corneal abrasion managed?

Answer 6

Topical antibiotics
Review only if not improved by next day
(common, minor trauma)

Question 7

Whta is sympathetic ophthalmoplegia?

Answer 7

Injury to one eye + exposure of intra-ocular antigens –> autoimmune reaction in both eyes
(inflammation in both eyes)

Question 8

What is the danger with sympathetic ophthalmoplegia?

Answer 8

May cause bilateral blindness from unilateral injury

Question 9

What is the management of chemical burns?

Answer 9

Quick history, check toxbase
Check pH
Irrigation +++ (at least 2 litres of saline)
Then assess at slit lamp

Question 10

What are the 6 golden rules for management of ocular trauma?

Answer 10

1. History is key
2. Always record visual acuity
3. Handle suspected globe fractures with care
4. Don’t forget fluorescein
5. Xray orbit if suspicious of intra-ocular foreign body
6. Immediate irrigation of chemical injuries with saline