Ocular Trauma Flashcards
List the logical order to examine the eye for signs of ocular trauma
Lids Conjunctiva Cornea Anterior segment Pupils Fundus
How do fluorescein drops help with examining the eye?
Identify areas of epithelial loss - absorb light of one wavelength and emit light of another wavelength
What is necessary to document when assessing ocular trauma?
Visual acuity
How do orbital blowout fractures occur?
Direct blow to orbit causes increased intraorbital fracture, leading to fracture of orbital wall (usually inferior)
List signs of an orbital blowout fracture
Severe swelling
Exophthalmus
Diplopia (damage to inferior rectus)
Numbness
What is the main imaging done for orbital blowout fractures?
CT
List potential causes of subconjunctival haemorrhage
Valsalva manoeuvre Trauma Contact lens Hypertension Bleeding disorders
How does subconjunctival haemorrhage usually present?
Unilateral red eye with mild irritation
Examination usually normal
What is a corneal abrasion?
Disruption in corneal epithelium
List causes of corneal abrasion
Trauma (fingernail, brush, particle)
Contact lens irritation
Ocular foreign body
UV keratitis
List symptoms + signs of corneal abrasion
Painful Redness, injected vessels Photophobia Ice-rink cornea Ulceration
What is traumatic uveitis?
Inflammation of iris due to trauma which causes necrosis
List early symptoms + signs of traumatic uveitis
Photophobia Decreased visual acuity Floaters Intra-ocular tears Diffuse redness
What is hyphema?
Accumulation of red blood cells within anterior chamber of the eye, a sign of severe intra-ocular trauma
Retinal detachment is an emergency. True/False?
True
How does retinal detachment arise?
Subretinal fluid accumulates between the neurosensory retina and retinal pigment epithelium
What are the signs and symptoms of retinal detachment?
Sudden flashes of light
Floaters
“heavy” eye
Shadow/veiled view
In optic nerve avulsion, the eye is untreatable and blindness will definitely occur. True/False?
True :(
Which connective tissue disease is associated with a dislocated lens?
Marfan’s syndrome (or any ligamentous laxity -associated CTD)
What happens in sympathetic opththalmia?
Penetrating to one eye causes bilateral inflammation and potential blindness in both eyes
How does corneal laceration usually arise?
Something sharp flying into/striking eye (fishhook, metal)
Explain Siedel’s test for corneal laceration
Apply fluorescein dye; if it appears diluted then there is likely to be a leak (positive test)
If you suspect an intra-ocular foreign body, what investigation is done?
XRAY
Water’s view
Which type of chemical burn in the eye is worse - acid or alkali - and why?
Alkali
More penetrating
Scarring changes to conjunctiva + cornea
Chemical burn is the only eye injury that needs treatment prior to history taking or examination. True/False?
True
Outline management of chemical burn in the eye
Copious irrigation using saline
Monitor pH
Topical anaesthetic if required
THE SOLUTION TO POLLUTION IS DILUTION
