Sports Med

Question 1

what signs would make you suspect a ruptured globe?

Answer 1

• flat anterior chamber
• hyphema
• blind eye
• obvious extravastation of orbital contents

Question 2

what does restricted upward gaze suggest?

Answer 2

• blowout fx and entrapment with damage to the extraocular mm.

Question 3

to check for corneal abrasions from foreign body?

Answer 3

• use fluorescein

- damage from a foreign body shows an ice rink sign

Question 4

Seidel test

Answer 4

• diagnostic of a ruptured globe; leakage of aqueous humor

Question 5

medications for corneal abrasions

Answer 5

• for contact lens wearers: fluoroquinolone or tobramycin (have to cover for Pseudomonas infections)
• no contact lenses = erythromycin ointment QID x 5d

Question 6

subconjunctival hemorrhage: S&S, tx

Answer 6

• painless, appears flat, no break in conjunctival membrane; not impinging on the iris
• blood is b/w the conjunctiva and the sclera
• usually resolves w/in 14d; can give artificial tears

Question 7

iritis - presentation and symptoms

Answer 7

• after blunt trauma to eye
• photophobia, eye pain
• limbal injection, miosis, mydriasis, VA (mild decrease = more severe case)

Question 8

hypopyon

Answer 8

• pus in anterior chamber

- severe iritis

Question 9

ddx of iritis

Answer 9

• corneal abrasion
• traumatic microhyphema
• traumatic retinal detachment

Question 10

iritis - management

Answer 10

• cycloplegic = pain d/t ciliary spasm = atropine
• NSAIDs for 3d
• sunglasses
• no antibiotics b/c even though there are white cells it’s an inflammation NOT an infection

Question 11

hyphema - presentation and management

Answer 11

• pain, blurred vision, hx of trauma; VA varies based on location
• traumatic hyphema - bleeding usually due to ruptured iris root vessel
• spontaneous - usually in sickle cell pts