Ocular Trauma And Emergency

Question 1

Types of ocular trauma

Answer 1

• penetrating ocular injury
• blunt trauma

Question 2

Mechanism of penetrating ocular injury

Answer 2

Direct trauma
- windscreen injury in MVA
- hammering a metal piece

Question 3

Symptoms of penetrating ocular injury

Answer 3

• pain
• reduced of vision
• photophobia
• lacrimation/tearing
• red eye
• presence of foreign body

Question 4

Signs of penetrating of ocular injury

Answer 4

• red eye
• abnormal pupil shape
• cornea laceration
• +/- ocular content
• flat anterior chamber

Question 5

Mx of penetrating ocular injury

Answer 5

• no external pressure on the eye
• shield eye
• never pad the eye
• refer immediately to
• systemic antibiotic
• anti tetanus
• xray/ct scan of orbit
• emergency toileting and suturing

Question 6

Mechanism of blunt trauma

Answer 6

• direct blow to eye
• eye will compressed antero- posteriorly
• sudden expansion of globe
• contusion and tearing damage

Question 7

Example scenario that leads to blunt trauma

Answer 7

• shuttlecock injury
• bullet toy
• tennis ball

Question 8

Immediate ocular injury and late ocular complication in BLUNT TRAUMA

Answer 8

Immediate ocular injury
- hyphaema +/- glaucoma
- subluxated lens
- vitreous haemorrhage
- retinal detachment

Late ocular complication
- traumatic cataract
- secondary glaucoma (angle recession)

Question 9

Symptoms of hyphaema

Answer 9

• reduced vision
• photophobia
• pain
• signs of intraocular pressure

Question 10

Complications of hyphaema

Answer 10

• hight intraocular pressure -> optic nerve damage
• rebleeding
• corneal endothelium staining
• peads: risk of amblyopia

Question 11

Mx of hyphaema

Answer 11

• complete bed rest
• control IOP: antiglaucoma agent
• control inflammation: steroid
• reduce spasm: cyclogyl
• surgery: if prolonged hyphaema/IOP is too high

Question 12

Complication of chemical injury

Answer 12

• necrosis of conjunctiva
• cornea stromal opacification
• iris and lens damage
• hypotony

Question 13

What to do if know pt has chemical injury?

Answer 13

• LA
• immediate irrigation
• do history taking while irrigating eye
• check ph before and after irrigation
• irrigation with normal saline atleast for half and hour (to achieve ph 7.0)
• remove loose material
• evert upper and lower eyelids
• refer immediately to

Question 14

Signs and symptoms of chemical injury

Answer 14

Symptoms
- pain
- reduced vision
- foreign body sensation
- photobia
- red eye (eyes can be very white -> severe ischemic)

Question 15

Treatment for chemical injury

Answer 15

• lubrication
• topical antibiotic
• cyclopegic
• surgical intervention; amniotic membrane transplant
• corneal scarring: corneal transplant