2-Trauma and ocular emergencies Flashcards Preview

Nayla Foundations > 2-Trauma and ocular emergencies > Flashcards

Flashcards in 2-Trauma and ocular emergencies Deck (45)
Loading flashcards...
1

What are symptoms of chemical conjunctivitis

acute pain, burning, blurry/impaired vision
may present with corneal abrasion
sclera can be red, pink, or white

2

How do you treat chemical conjunctivitis

IRRIGATE!!!!! Irrigate more (2L) if alkaline substance
then, topical lubricants. refer to ophthalmology

3

What causes a subconjunctival hemorrhage

Trauma, or trivial events like sneezing, coughing, valsalva

4

What are signs of subconjunctival hemorrhage

usually acute and asymptomatic
vision is not affected
Redness stops at the LIMBUS

5

Does subconjunctival hemorrhage require treatment

No, just reassurance
Should resolve in 2-4 weeks

6

What is a hyphema

injury to anterior chamber disrupting vasculature to ciliary body, causes blood to pool

7

What are symptoms of hyphema

acute onset pain
photophobia
tearing
N/V due to IOP

8

What will you see on hyphema PE

+/- visual acuity
layered heme in anterior chamber

9

How do you treat Hyphema

Ophth referral THAT DAY
bed rest, supine wit head slightly ELEVATED
Need to control IOP and ease discomfort

10

What meds are used in Hyphema treatment

Oral diuretic (acetazolamide [carbonic anhydrase inhibitor])
topical diuretic (dorzolamide)
topical cycloplegic
+/- topical steroid

11

What are symptoms of conjunctival/corneal FB

+/- Hx of something in eye
pain
inability to open eye
May have attempted irrigation
tearing, conjunctival injection, FB presence
Vision usually NOT affected

12

How do you preform a FB exam

topical anesthetic (tetracaine)
Check visual acuity pre and post
every eyelid (look for FB)
fluorescein if suspected abrasion
Pupil exam if suspected intraocular FB (REFER)

13

How do you treat FB

FB removal (irrigation/cotton swab)
Lubricant/abx drops
Refer to ophtho if you can't remove FB, or large abrasion

14

What causes a perforated globe

penetrating trauma (hammering/shaving metal)
EMERGENCY surgical referral

15

What will you see on PE if with perforated globe

loss of anterior chamber depth
misshapen pupil
vitreous leakage (jelly)

16

How do corneal abrasion patients present

acute onset pain
FB sensation
Tearing
Light sensitivity
Cant open eyes

17

What do you see on corneal abrasion PE

+/- affected vision
visible epithelial defect
abrasions with fluorescein and black light

18

What is a corneal abrasion

abrasion in corneal epithelial tissue often due to trauma by paper, nail, or contact

19

How do you treat corneal abrasion

topical Abx/lubricant
Heals quickly, F/u 1-2 days

20

Why shouldn't you send a patient home with anesthetics

they inhibit healing
Patient can't protect eyes due to lack of sensation
Anesthetic keratitis occurs with overuse, needs corneal transplant

21

What is Keratitis

corneal ulcer most commonly due to infection (bacteria, virus, fungi, or amoebic)
Often associated with contacts

22

What are symptoms of keratitis

eye pain, photophobia, tearing, decreased vision

23

What will you see on keratitis PE

injected conjunctiva (esp. by limbus)
cloudy, hazy opacity overlying cornea
+/- hypopyon (pus in ant. chamber)
Dendritic pattern on fluorescein (HSV)

24

How do you treat keratitis

Opto referral promptly
Moxifloxacin (bacterial)
topical acyclovir 9x day (HSV)

25

What is Uveitis/iritis

inflammation of uvea (includes iris, ciliary body, choroid)
commonly immunologic, can be caused by trauma

26

What are symptoms of uveitis

Eye pain, redness, photophobia, HA, tearing

27

What will you see on uveitis PE

decreased vision
Ciliary flush (circumlimbal)
constricted pupils
cells (dust thru flashlight) and flare (headlights in fog) (slit lamp)
low/norm IOP

28

Why are cells and flare present on exam

inflammation of uveal tract allows proteins and WBC into aqueous humor

29

What are possible causes of uveitis

HSV, herpes zoster
Ankylosing spondylitis, arthritis, IBS

30

How do you manage uveitis

Prompts Ophtho referral
topical steroids
topical cycloplegics