VII Flashcards

1
Q

Flat anterior chamber = ?

A

Loss of aqueous humor

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2
Q

What may happen to the iris with trauma?

A

Plug, iritis, hyphema

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3
Q

Is a TDaP needed post ocular trauma?

A

Yes

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4
Q

Hammering on metal = ?

A

Intraocular FB

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5
Q

H/o grinding things = ?

A

Corneal FB

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6
Q

H/o welding = ?

A

Corneal UV burn

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7
Q

h/o racquet sports = ?

A

Hyphema

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8
Q

H/o fist fights = ?

A
  • Hyphema
  • BOF
  • ruptured globe
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9
Q

What are the basic exam bits with ocular trauma?

A
  • VA
  • External exam
  • Pupils
  • Motility exam
  • Anterior segment
  • Ophthalmoscopy
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10
Q

What are the two true ocular emergencies?

A

Chemical burns

CRAO

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11
Q

What are the two semi urgent ocular problems?

A
  • Orbital fractures

- Subconjunctival hemorrhages

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12
Q

Which is more serious: alkali or acid burns to the eye?

A

Alkali

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13
Q

What is the immediate treatment for chemical burns?

A

Immediate irrigation

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14
Q

A lack of redness in the eye with chemical burns = ?

A

Ischemic Necrosis and badness

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15
Q

Corneal epithelium is derived from what?

A

Specialized area of the conjunctiva, that dedifferentiate, migrate centrally.

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16
Q

After irrigation, what are the three next steps in the care of chemical burns to the eye?

A
  • Instill topical anesthetic
  • Check for FBs
  • Institute copious irrigation
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17
Q

What (general) amount of fluid is needed for irrigation of the eye? What type of fluid should be used to irrigate?

A

Liters

Anything

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18
Q

What topical agent should be used for chemical burns?

A

Cycloplegic agent and topical abx

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19
Q

Which is an immune privileged site: cornea or conjunctiva?

A

Cornea

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20
Q

What are the s/sx of corneal abrasion?

A
  • FB sensation
  • Pain
  • Tearing
  • Photophobia
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21
Q

What is the classic mimic of corneal abrasions?

A

HSV

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22
Q

How do you treat a corneal abrasion?

A

-Topical abx solution and topical NSAIDs (ketorolac)

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23
Q

What is the role of oral analgesics with corneal abrasions?

A

Ineffective

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24
Q

What is the role of prescribing topical abx for corneal abrasions?

A

Prophylaxis for infection of the eye

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25
Q

When should f/u be done with corneal abrasions?

A

24 hours

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26
Q

When should corneal abrasions be referred to an ophthalmologist?

A
  • Not healed in 24 hours
  • Abrasion related to contact lens wear
  • White corneal infiltrate
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27
Q

When should patches NOT be used for corneal abrasions? (3)

A
  • Contact lens wearers
  • Dendritic or stellate epithelial defects
  • Poor historians
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28
Q

What is acanthamoeba?

A

Keratitis (or encephalitis) causing parasite, often found in contact lens wearers

29
Q

Why are topical anesthetic prescriptions contraindicated with corneal ulcerations?

A

Corneal toxicity

30
Q

What must be done with rust rings?

A

Must be taken out in a few days, o/w will not heal

31
Q

Pooling of the aqueous humor =? What should be done?

A

Full penetration or the cornea

Shield the eye and refer

32
Q

What is the best imaging modality for FB in the eye?

A

head CT

33
Q

True or false: hyphemas should always be assumed as a globe rupture, and be referred

A

True

34
Q

What are the complications from hyphemas? (2)

A
  • Rebleeding into the anterior chamber

- Glaucoma

35
Q

If the globe is ruptured, what should be done?

A

Stop exam, shield eye, give TDaP, and refer immediately

36
Q

How do you treat proptosis of the eye 2/2 severe orbital hemorrhage?

A

Decreased the pressure behind the eye

37
Q

What can severe orbital hemorrhage lead to?

A

-Blindness 2/2 increase IOP

38
Q

What are the complications from severe orbital hemorrhage?

A
  • Bullous subconjunctival hemorrhage
  • Proptosis
  • Corneal exposure
39
Q

What is the treatment for severe orbital hemorrhage?

A

Emergent lateral canthotomy

40
Q

What is an Emergent lateral canthotomy?

A

Cutting the canthus to relieve pressure in the eye

41
Q

What are the s/sx of orbital fractures? (4)

A
  • Periorbital edema
  • Ecchymosis
  • Diplopia
  • SQ emphysema
42
Q

What can cause the numbness down to the cheek with orbital fracture?

A

Irritation from V2

43
Q

What are the two indications for surgery 2/2 orbital fracture?

A
  • Persistent diplopia

- Poor cosmesis (enophthalmos)

44
Q

What is a blow-out fracture?

A

Muscles extend into the maxillary sinus

45
Q

Young children under 15 need to be fixed within what timeframe? Why?

A

3-5 days

Need to reduce the scarring and inflammation that occurs. O/w interferes with development

46
Q

Why should you avoid lid retraction with superficial lid lacerations?

A

Will have tearing their entire lives if tear ducts are involved

47
Q

What should be done to treat superficial lid lacs (3)?

A
  • Remove superficial FBs
  • R/o deeper FBs
  • Give TDaP
48
Q

Should you debride tissue with dog bites in the eye?

A

No–want plastic surgeon to do it

49
Q

What can cause UV keratitis?

A
  • Welder’s burn

- Snow blindness

50
Q

What is UV keratitis?

A

UV rays irritate the superficial corneal epithelium, causing inhibition of mitosis, production of nuclear fragmentation, and loosening of the epithelial layer

51
Q

What are the s/sx of UV keratitis?

A
  • Photophobia
  • FB sensation
  • Tearing
  • Pain
52
Q

What is the treatment fro UV keratitis? (2)

A
  • Cycloplegics

- analgesics

53
Q

What usually causes traumatic optic neuropathy?

A

Damage to the head to directly to the orbit

54
Q

What are the direct causes of traumatic optic neuropathy?

A

Lac of the ON, intraorbital hemorrhage

55
Q

What are the indirect causes of traumatic optic neuropathy?

A

Shear forces on nerve or vascular supply

56
Q

What are the s/sx of traumatic optic neuropathy? (2)

A

Visual loss is severe and immediate

RAPD

57
Q

What is the treatment for traumatic optic neuropathy?

A
  • Orbital or cranial surgery

- Therapy for indirect traumatic ON

58
Q

What is the general treatment for corneal abrasions?

A
  • Topical cycloplegics

- Topical abx ointment

59
Q

White corneal infiltrate around abrasion = ?

A

It’s not a corneal abrasion–it’s an ulcer

60
Q

When should ER docs not take out a FB in the eye?

A

If it is near the pupil or an area that the pupil will cover with dilation

61
Q

What happens can happen to the retina with blunt trauma?

A

Cracking of the retina, and exposure of the choroid

62
Q

Cherry red spot on fundoscopic exam = ?

A

CRAO

63
Q

What is the relative platelet count with anterior ischemic optic neuropathy?

A

Elevated

64
Q

What are the two treatments that must be done with suspected anterior ischemic optic neuropathy?

A

IV steroids

Obtain temporal artery bx

65
Q

Teardrop pupil and flat A/c = ?

A

Penetrating injury

66
Q

True or false: you should avoid digital palpation of a traumatic eye

A

True

67
Q

What must be r/o with FB to the eye before getting an MRI?

A

Metal FB

68
Q

What are the indication for prescribing a topical anesthetic?

A

NEVER