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PHA 521 > TRAUMA AND OCULAR EMERGENCIES > Flashcards

TRAUMA AND OCULAR EMERGENCIES Flashcards

1
Q

Chemical Conjunctivitis

A

caustic chemical exposure

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2
Q

Chemical Conjunctivitis: symptoms and signs

A

symptoms:

  • acute pain/burning
  • blurry/impaired vision

signs:

  • decreased visual acuity
  • corneal abrasion
  • red, pink, white
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3
Q

Chemical Conjunctivitis: treatment

A

irrigation
topical lubricants
antibiotics
refer

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4
Q

Subconjunctival Hemorrhage

A

blood under the conjunctiva due to vessel rupture

cause: trauma, trivial events (cough, sneeze, valsalva)

resolve in 2-4 wks

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5
Q

Subconjunctival Hemorrhage: signs and symptoms

A

symptoms:
- acute
- asymptomatic

signs:

  • vision unaffected
  • diffuse, flat red patch that stops at limbus
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6
Q

Hyphema

A

results from injury to the anterior chamber that disrupts the vasculature supporting the iris or ciliary body

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7
Q

Hyphema: signs and symptoms

A

symptoms:

  • acute onset pain
  • photophobia
  • tearing
  • N/V

signs:
+/- decreased vision
layered heme in anterior chamber

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8
Q

Hyphema: management

A 
refer
bed rest (supine, head elevated)
control IOP (diuretics)
ease discomfort
prevent complications (prevent synechiae)(cyclopegic)
decrease inflammation (steroid)
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9
Q

Conjunctival and Corneal Foreign Body: symptoms

A

+/- history of something entering eye
pain
inability to open eye

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10
Q

Conjunctival and Corneal Foreign Body: signs

A 
unaffected vision
tearing
conjunctival injection
presence of foreign body
staining with fluorescein if abrasion
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11
Q

Conjunctival and Corneal Foreign Body: treatment

A

irrigation or cotton swab

lubricant or antibiotic eye drops

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12
Q

Perforated Globe

A

result from penetrating trauma

signs:

  • loss of anterior chamber depth
  • misshapen pupil
  • vitreous leakage

emergency referral
avoid manipulation

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13
Q

Corneal Abrasion

A

defect in corneal epithelial tissue

trauma (fingernail, paper, contact lens)

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14
Q

Corneal Abrasion: symptoms

A 
acute onset pain
foreign body sensation
tearing
light sensitivity
inability to open eyelids
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15
Q

Corneal Abrasion: signs

A

+/- vision affected
visible epithelial defect
abrasions

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16
Q

Corneal Abrasion: management

A

topical antibiotic
topical lubricants

heals quickly

17
Q

Corneal Ulcer (keratitis)

A

commonly due to infection

associated with contact lens abuse

18
Q

Corneal Ulcer: symptoms

A

eye pain
photophobia
tearing
decreased vision

19
Q

Corneal Ulcer: signs

A

conjunctival injection
cloudy, hazy opacity overlying cornea
+/- hypopyon

dendritic pattern on fluorescein staining (HSV)

20
Q

Corneal Ulcer: treatment

A

refer

antibiotics

21
Q

Uveitis/Iritis

A

Inflammation of the uvea (iris, ciliary body, choroid)

Most commonly: immunologic

also: trauma

22
Q

Uveitis/Iritis: symptoms

A 
eye pain
redness
photophobia
headache
tearing
23
Q

Uveitis/Iritis: signs

A 
decreased vision
ciliary flush/circumlimbal injection
constricted pupils
cells and flare (SLE)
normal or low IOP
24
Q

Uveitis/Iritis: diagnosis

A

infectious cause

  • HSV
  • herpes zoster

systemic inflammatory cause

  • ankylosing spondylitis
  • arthritis (JIA)
  • inflammatory bowel disease
25
Q

Uveitis/Iritis: management

A

refer
topical steroids
topical cycloplegics

26
Q

Blow Out Fracture

A

direct compressive force to the globe

diagnose with CT

orbital floor: zygomatic, maxillary, palatine bones

27
Q

Blow Out Fracture: clinical presentation

A 
pain
diplopia
restricted EOMs
decreased sensation
palpable step off
enophthalmos
28
Q

Blow Out Fracture: treatment

A

refer

empiric antibiotics

29
Q

Glaucoma

A

group of ocular diseases

changes in the optic dick and progressive loss of visual fields

30
Q

Glaucoma: classification

A

Acute Angle Closure Glaucoma

  • emergency
  • rare

Chronic Open Angle Glaucoma
-most common

31
Q

Acute Angle Closure Glaucoma

A

pre-existing narrow anterior chamber angle (secondary to pupil dilation)

outflow obstructed (pupillary block) –> pressure builds

32
Q

Acute Angle Closure Glaucoma: clinical presentation

A 
extreme eye pain
headache
photophobia
blurred vision with halo around lights
N/V
33
Q

Acute Angle Closure Glaucoma: physical exam

A 
appears sick
decreased vision
red eye (circumlimbal injection)
steamy cornea 
fixed mid-dilated pupil
crescent shadow
increased IOP (frim globe, P>50)
34
Q

Acute Angle Closure Glaucoma: treatment

A

control IOP

  • dec aqueous production (acetazolamide, timolol)
  • constrict pupil (mitotic drop)

Laser peripheral iridotomy

35
Q

Chronic Glaucoma

A

gradually progressive nerve damage (cupping + pallor)–> loss of vision (constriction of visual field to blindness)

increased IOP

  • chronic open angle (reduced drainage through trabecular network)
  • chronic closed angle (obstruction of flow into anterior chamber)
36
Q

Chronic Glaucoma: prevention

A

all persons over 40 :

  • dilated fundus exam
  • IOP measurement

every 2-5 years

37
Q

Chronic Glaucoma: clinical presentation

A

asymptomatic

bilateral

38
Q

Chronic Glaucoma: diagnosis

A

consistent, reproducible abnormalities in 2/3:

  • optic disk
  • visual field
  • IOP
39
Q

Chronic Glaucoma: treatment

A

lower IOP

  • refer
  • anti-ocular hypertensives
  • laser trabeculoplasty
  • surgical trabeculoplasty

variable prognosis

PHA 521 (12 decks)

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