Trauma (Ocular Disease) Flashcards
What type of trauma may you see?
- Chemical burn
- Conj/corneal FB
- Hyphema
- Fracture
- Commotio Retinae
- Purscher’s Retinopathy
- Choroidal Rupture
Which burns are worse, alkali or acidic?
ALKALI
These damage FA membranes and therefore penetrate faster through epi
What does blanching indicate in a chemical burn?
Ischemia
How do you manage a conj/corneal FB?
- R/O metallic (no MRI) vs non-metallic (veg matter, fungi)
- Stains w FL
- Look for underlying infiltrate
- Seidel sign?
What should you consider when you see a hyphema?
- Systemic disease (i.e. sickle cell)
- Blood thinners (i.e. warfarin/aspirin)
- Trauma
When would you perform gonioscopy or scleral depression on these pt’s?
1 month POST-injury to AVOID re-bleeding!
NOTE: re-bleeds tend to be WORSE than original presentation
When is a B-scan indicated for a hyphema?
If hyphema occludes view of fundus & concerned about RD!
What is iridodialysis?
Dis-insertion of IRIS ROOT from CB
What is Vossius ring?
Pigment on ANTERIOR lens capsule from trauma
What is corectopia?
displacement of pupil (i.e. due to sphincter tear)
What is the #1 cause of lens subluxation?
TRAUMA
What % of pts w hyphema will also present w angle recession?
60% of cases bc iris pulls away from longitudinal muscle of CB
Which bone is most commonly affected in an orbital fracture?
Maxillary bone!
BC orbital FLOOR blow-out fractures are the MOST COMMON due to how weak it is
Symptoms of orbital fracture?
- Pain
- Diplopia OU
- CREPITUS on palpation
- (+) FD
- Enophthalmos
- Globe ptosis (don’t blow nose!
What is the pathophysiology of commotio retinae?
Disruption of RPE & PR outer segments (grey white discoloration) due to trauma
How long does commotio retinae resolve?
24-48 hours!
NOTE: permanent vision/VF loss may occur still
Commotio retinae at macula is called what?
Berlin’s edema
How do you Tx commotio retinae?
Scleral indent to evaluate for breaks
RTC for commotio retinae when?
2 weeks
Which traumatic eye disease is associated with compressions of the chest, diffuse retinal hemes, CWS, high IOP, & burst retinal arteries?
Purtscher’s retinopathy
Choroidal Ruptures look like what in the retina?
MC a single area or multiple areas of sub-retinal hemorrhage, temporal posterior pole w CRESCENT shaped tears concentric to ONH
What may result from a choroidal rupture that affects vision greatly?
CNVM!
Bruch’s membrane is inelastic and more prone to rupture!
Tx for choroidal rupture?
Amsler grid: 6-12 months
Anti-VEGF agents
