Trauma Flashcards
what is used to identify areas of trauma/epithelial loss
fluorescein drops
what fracture is commonest in the eye
blowout fracture
what are complications of a blowout fracture
orbital contents can herniate into the maxillary sinus
IR and IO can get damaged and cause diplopia
Infraorbital nerve injury
what indicates infraorbital nerve injury
loss of sensation over the lower lid skin
what is a subconjunctival haemorrhage
harmless but alarming pool of blood behind the conjunctiva
what should be investigated in subconjunctival haemorrhage
are they on warfarin
BP
what is contained within the uvea
iris
ciliary body
choroid
Sx of uveitis
Acute pain photophobia decreased visual acuity lacrimation (watery discharge) corneal redness small pupil
what test is positive in uveitis
Talbot’s test
what is hyphema
blood in the anterior chamber
sign of significant trauma
what is an 8 ball hyphema
when the eye is completely covered by blood, appears black
what are the 4F’s of retinal detachment
Floaters (numerous, acute onset, constant, described as ‘spiders web’)
Flashes
Field loss (acute, progressive)
Falling acuity (painless, ‘curtain falling down across vision)
what can cause retinal detachment
trauma
cataract surgery
rhegmatogenous (most common)
what does rhegmatogenous mean
occurs after a retinal tear leads to fluid accumulation with a separation of the retina from the underlying epithelium
what does a half white moon seen on fundoscopy indicate
choroidal tear
what is commotio retinae
bruised retina
after trauma, tends to settle itself over days-weeks
can loss vision in a visual field for a period of time
can result in reduced vision in the long term
what is optic nerve avulsion
optic nerve completely pulled out and detached
lose full vision in that eye
what can be used to assess anterior chamber leakage into the cornea
Siedel’s Test
what is sympathetic ophthalmia
Penetrating injury to one eye
- exposure of intra-ocular antigens
- auto-immune reaction in both eyes
what happens in sympathetic ophthalmia
Inflammation in both eyes
May lead to bilateral blindness (from a unilateral injury)
what can a foreign body in the eye cause
chemosis subconjunctival bleeds irregular pupils iris prolapse hyphema retinal tears
what should always be done when a history of intra-ocular foreign body
X-ray
how should chemical burns be treated
anaesthetic drops
bathe the eyes with copious amounts of water/irrigation
what are complications of chemical burns
limbal ischaemia corneal scarring corneal vascularisation lid damage opacification
what are the golden rules of ocular trauma
- History is key
- Always record visual acuity
- Don’t forget Fluorescein
- Handle suspected globe rupture with care…
- X-Ray orbits if suspicion of Intra-Ocular Foreign Body (IOFB)
- Immediate irrigation of chemical injuries
(the solution to pollution is dilution!)
