Ocular Trauma

Question 1

What are Lefort fractures?

Answer 1

Fractures of the Mid-Face

3-Stage Classification
Lefort 1
Lefort 2
Lefort 3

Question 2

Explain the fractures:

Lefort 1
Lefort 2
Lefort 3

Answer 2

Lefort 1 - Palate (Guerin Fracture
Lefort 2 - Nose + Palate
Lefort 3 - Entire face

Question 3

Blowout fracture commonly affects which part of the Orbit?

What’s the characteristic sign seen of XR

Management

Answer 3

Fracture of the floor of the orbit. Typically the maxillary bone.

Tear drop sign

Conservative awaiting swelling to reduce, Surgical repair for resistant diplopia.

Question 4

Which chemicals cause more serious issues to the eye?

Acid or Alkali materials

Answer 4

Alkali materials.

Question 5

What features of the eye can be use to assess the extent of damage by chemical injury?

Answer 5

The Cornea - More Opaque the worse it is.

LIMBAL ISCHAEMIA -

Question 6

Management for chemical eye injury?

Answer 6

Test the pH, then instill topical anaesthetic and irrigate with water.

Medicines - Steroids? Antibiotics? Artificial tears? Cycloplegia?

Question 7

If an IOFB (Intraocular Foreign Body) affects one eye what must you remember?

Answer 7

CHECK BOTH EYES during the examination

Check eyelids for lacerations

Assess posterior segment - Via funduscopy

Question 8

Management of IOFB?

Answer 8

Prophylactic antibiotics - systemic ciprofloxacin.

In cases of contaminated IOFB, intravitreal antibiotics (vancomycin + ceftazidime) are considered.

Surgical removal (use of magnets or forceps).

Question 9

Complications of IOFB?

Answer 9

Angle recession glaucoma (Open angle glaucoma as a result of ocular trauma)

Sympathetic ophthalmia in the fellow eye. (Granulomatous inflammation bilateral
Endophthalmitis.
Red cell glaucoma (Due to RBC debris from hyphema - pooling of blood in the anterior chamber)