Trauma

Question 1

What happens in a corneal abrasion?

Answer 1

Trauma that results in the removal of a focal area of epithelium on the cornea often when eye is accidentally poked with a finger, a foreign body flies in or something bushes against it.

Question 2

Under blue light after fluorescein what colour will corneal abrasions show up?

Answer 2

Green

Question 3

Signs and symptoms of corneal abrasion?

Answer 3

Severe pain, lacrimation, inability to open eye, blinking and movement can aggravate pain and visual acuity is usually reduced.

Question 4

Treatment of a corneal abrasion?

Answer 4

Broad spectrum topical antibiotic such as chloramphenicol

Question 5

What should be suspected in high velocity trauma or involving fast moving particles such as in metal work?

Answer 5

Corneal perforation or intraocular foreign body

Question 6

Describe difference between acid and alkali burns?

Answer 6

Acids coagulate proteins and have little penetration
Alkali have rapid penetration and penetrates the intraocular structures
Alkalis cause more damage than acid
Alkali burns look for development of ischaemia at edge of limbus- if stem cells become ischaemic can lead to poor corneal healing. Total limbal ischaemia- complete white eye.
Worried about corneal scarring.

Question 7

With penetrating trauma what rare reaction should you remember?

Answer 7

Sympathetic ophthalmia- penetrating injury in one eye can cause autoimmune reaction in both eyes- bilateral blindness

Question 8

Describe siedels test?

Answer 8

When instilled into the eye, the dye is taken up by defects in the cornea such as abrasions or lacerations.Seidel testispositivewhen the fluorescein dilutes in the aqueous humor and causes it to fluoresce bright green and stream down the eye with gravity. A positive test indicates that there is a leakage of aqueous humor from the anterior chamber, which is an ocular emergency.

Question 9

What happens in a globe rupture?

Answer 9

the integrity of the outer membranes of the eye are disrupted by blunt or penetrating trauma, usually resulting from a full-thickness injury to the cornea or sclera

Question 10

Does subconjunctival haemorrhage always signify significant injury?

Answer 10

No

Question 11

Describe the role of fluorescein?

Answer 11

Fluoroscein drops help identify areas of trauma and epithelial loss.

Fluorescein does not stain a normal cornea but conjunctival abrasions are stained yellow or orange, corneal abrasions or ulcers are stained a bright green and foreign bodies are surrounded by a green ring.

Question 12

Treatment of chemical burns?

Answer 12

Irrigate eye as quickly as possible- at least 2l of saline, check pH