Flashcards in 2-Trauma and ocular emergencies Deck (45)
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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
