Week 2 - A - Ocular Trauma

Question 1

What are the layers of the cornea? What dye is used to assess these layers?

Answer 1

Epithelium, Bowman’s membrane, stroma, descemet’s membrane and endothelium Fluorescein dye

Question 2

What kind of fracture can occur due to blunt trauma to the orbit?

Answer 2

Can cause a blowout fracture to occur

Question 3

What is the process of the blowout fracture?

Answer 3

Blunt trauma to orbit Results in the pressure hitting the eye being forced downwards causing the (usually maxillary bone) to fracture and eye contents are herniated through

Question 4

What muscle can be caught in a orbital blowout fracture? What two things can this cause?

Answer 4

Inferior rectus can be caught This cause an inability to look up and vertical double vision

Question 5

What is the treatment of an orbital blowout fracture?

Answer 5

Treatment is surgery

Question 6

What is the usual red eye known as which is caused by blood thinners?

Answer 6

Subconjunctival haemorrhage - presents with injected vessels

Question 7

usually occurs due to trauma causing blood vessels to rupture – patient can be sensitive to light This is blood in the anterior chamber of the eye, what is this known as?

Answer 7

Hyphaema

Question 8

 Usually need topical anaesthetic drops such as oxybuprocaine or tetracaine in order to examine the eye with corneal abrasion What are some of the causes of corneal abrasions?

Answer 8

Foreign body in the eye Eye being poked with a finger

Question 9

What is a good treatment for a corneal abrasion?

Answer 9

Topical chloramphenicol

Question 10

Dendritic ulcer on cornea, what is the cause?

Answer 10

Herpes simplex keratitis

Question 11

Treatment of herpes simplex keratitis?

Answer 11

Acyclovir ointment

Question 12

What condition is it where you can get flashers and floaters?

Answer 12

Retinal detachment

Question 13

What are the risk factors for retinal detachment?

Answer 13

Ageing and severe nearsightedness (myopia)

Question 14

What is the test used to assess the presence of anterior chamber leakage in the cornea? What do you visualise the light under? * It is used as a screening test for many corneal disorders including corneal post-trauma, corneal perforation and corneal degeneration.

Answer 14

Siedel’s test - put fluroscein dye on the eye. When instilled into the eye, the dye is taken up by defects in the cornea such as abrasions or lacerations. Seidel test is positive when the fluorescein dilutes in the aqueous humor and causes it to fluoresce bright green and stream down the eye with gravity. Visualise the eye under cobalt blue light

Question 15

Penetrating injury to one eye exposure of intra-ocular antigens auto-immune reaction in both eyes Inflammation in both eyes What is this?

Answer 15

Sympathetic opthalmia

Question 16

For chemical burns, do acids or alkali damage the eye more?

Answer 16

Alkali are more dangerous as they can penetrate intra-ocular structures Acids however coagulate with the proteins and therefore do not penetrate deeper into the eye

Question 17

How is a chemical burn treated?

Answer 17

Irrigation - pour saline into eye (2L) Immediate irrigation of chemical injuries (the solution to pollution is dilution!)

Question 18

What are the six golden rules?

Answer 18

1. History is key 2. Always record visual acuity 3. Don’t forget Fluorescein 4. Handle suspected globe rupture with care… 5. X-Ray orbits if suspicion of Intra-Ocular Foreign Body (IOFB) 6. Immediate irrigation of chemical injuries (the solution to pollution is dilution!)