Ophthalmology

Question 1

• What tests should be done if ocular foreign body is suspected?
• What is the role of ophthalmology?

Answer 1

• Obtain visual acuity and flourescein dye examinations.
• If suspected foreign body is radiopaque obtain xray vs CT
• Ophthalmology should be consulted to rule out globe injury and perform tonometry if indicated

Question 2

Describe ocular gaze deviations expected in the following orbital fractures:

• lateral
• medial
• superior
• inferior

Answer 2

• They all just have a defect with the opposite type movement!
• lateral=medial gaze defect
• medial=lateral gaze defect
• superior=inferior gaze defect
• inferior=superior gaze defect

Question 3

• Describe a presentation of orbital cellulitis
• What are common etiologies of orbital cellulitis?
• How should this be managed?

Answer 3

• often 2/2 sinusitis or evolved periorbital cellulitis!
• unilateral proptosis+double vision following sxs consistent with sinusitis
• Treat this as an emergency and get immediate ophthalmology consultation as infxn can spread to the brain

Question 4

What is a hordeolum?
What is a chalazion?
Which one is painful?
Which one is associated with infection?

Answer 4

• A hordeolum, commonly known as a “stye” is an infection of the hair follicles and eyelashes (external hordeolum) and/or the meibomian glands (internal hordeolum). Staphylococcus aureus is the causative agent in well over 90% of cases. Most cases are unilateral. As an infectious process, a hordeolum is often painful.
• On the other hand, a chalazion is a granuloma involving the meibomian glands. Chalazions are usually painless.