eye trauma Flashcards
occular trauma
common especially in developing conutries.
can involve any part of the ocular system (eyelids, globe, visual pathways)
periorbital haematoma
haematoma (a black eye) is the most common result of a blunt injury to the eyelid
signs: ecchymosis (bruise / discoloration due to rupture of blood vessels below the surface of the skin)
management: self-resolve. cool compress. analgesia
*if bilateral involvement, rule out a skull base fracture.
orbital blow out
blowout fracture of the orbital floor from a sudden increase in orbital pressure (striking object)
signs: enophthalmos (sinking of the eyeball into the orbit), diplopia, infraorbital nerve anesthesia, limitations of upgaze limitation
investigation: CT scan
management: surgical repair
lid laceration
ensure the lacrimal system is intact. improper eyelid closure can cause exposure keratopathy.
management: direct horizontal closure (best functional and cosmetic results) major tissue loss needs oculoplastic surgery.
lid laceration
ensure the lacrimal system is intact. improper eyelid closure can cause exposure keratopathy.
management: direct horizontal closure (best functional and cosmetic results) major tissue loss needs oculoplastic surgery.
subconjunctival hemorrhage
blood under the conjunctiva. normally unilateral, localized sharply circumscribed. no inflammation, pain or discharge, and visual acuity is unchanged. often hx of eye rubbing/coughing.
mx: reassurance, BP, coagulation.
chemical burns to cornea
alkalis (bleach/cement) can penetrate deeper into the ocular structures than acids. ocular emergency.
signs: corneal haze, limbal ischemia, loss of epithelium.
mx: copious irrigation with normal saline until ocular pH remains normal- under topical anesthetic.
intensive steroids, antibiotics, eye lubricants
limbal stem cell grafting from limbal stem cell loss
keratoplasty/keratoprosthesis (artifical cornea) surgery may be required for dense corneal scarring.
superficial foreign body
foreign body on corneal surface / bulbar conjunctiva. if foreign body is not visible can evert the eyelids to expose a possible subtarsal foreign body
mx: removal of the foreign body. topical antibotics.
eye globe perforation
scleral rupture
corneal rupture
severe blunt trauma trauma and perforating occular trauma
signs: soft eye, protruding irs, irregulr pupil.
risk of infection and symapthetic opthalmia
mx: surgical primary repair
hyphaema
blood in the anterior chamber following blunt trauma to the eye
symptoms: red eye, severe vision loss, trauma
signs: visible blood in the anterior chamber and cornea may be stained. sore if IOP raised. cloudy vision
mx: bed rest. typical ATROPINE (Reduce risk of bleeding) r/v with urgent opthalmologist. anterior chamebr irrigation
Iridodialysis
dehiscence (partial/total separation of previously approximated wound edges) due to failure of proper wound healing. causes- blunt trauma o the eye, penetrating eye injuries.
symptoms: asymptomatic, monocular diplopia and glare
signs: misshapen pupil
mx; surgical iridoplasty
cataracts
can arise from direct penetrating injuries to the lens.
imprinting of the iris pigment onto the anterior lens
rosette shaped cortical opacity.
mx: cataract extraction and intraocular lens implantation
lens subluxation / dislocation
direct trauma to the eye can can cause lens subluxation / total dislocation.
symptoms- reduced vision, monocular diplopia, IO hypertension
mx: lens removal and intraocula lens implantation
intra ocular foreign body
An IOFB may lodge in any of the ocularstructures it passes through, so may be located anywhere from the anterior chamber, lens to the retina and choroid.
Foreign bodies are prone to result in infection (endophthalmitis).
Management: immediate referral to ophthalmologist for removal of foreign
body
