Ophthalmic emergencies Flashcards
1
Q
Main ocular emergencies
A
- chemical burns
- CRAO
- ischaemic optic neuropathy
- endophthalmitis
- suppurative keratitis
- acute glaucoma
- penetrating eye injury
- orbital cellulitis
- CN3 palsy
2
Q
Pathology of chemical damage
A
- conjunctival damae leads to adhesions between tarsal and bubal conjunctiva
- corneal damage leads to opacification and vascularisation
- glaucoma results from destroyed trabecular meshwork
3
Q
Causes of endophthalmitis
A
- post-surgical
- post-traumatic
- endogenous
4
Q
Signs and symptoms of endophthalmitis
A
- history of recent surgery
- sudden pain in eye with loss of vision
- red eye with swollen lid
- hypopyon
- loss of RR (advanced)
- APD (advanced)
5
Q
Causes of suppurative keratitis
A
- N. gonorrhoea
- P. aeruginosa
- fungal
- protozoal
6
Q
Pathogenesis of acute glaucoma
A
- when pupil mid-dilated, pupil is in contact with the lens
- pupil block so aqueous builds up in posterior chamber
- peripheral iris pushed into contact with cornea
- covers trabecular meshwork
- blocks outflow
7
Q
Acute management of acute glaucoma
A
- analgesics and anti-emetic
- aqueous suppressants (acetazolomide 500mg orally and levobunolol one drop)
- refer immediately
- mannitol IV to dehydrate eye osmoically
- pilocarpine used to constrict pupil once IOP reduced
- peripheral iridotomy when cornea clears
8
Q
Management of orbital cellulitis
A
- admit and start IV ampicillin and metronidazole
- urgen CT
- refer to ENT for drainage of sinuses
