Eye injuries Flashcards
Define corneal abrasion.
scratch/ damage to cornea
How do corneal abrasions occur?
- Contact lens – may be associated infection w/ pseudomonas.
- Foreign body
- Fingernail/ eyelashes
- Entropion
- Chemicals, e.g acid – severe eye damage and vision loss.
How does corneal abrasion present?
- Painful, red eye – due to dilation of blood vessels on surface.
- Foreign body sensation
- Watery eye
- Blurry vision
- photophobia
How is corneal abrasion diagnosed?
- fluorescein stain (yellow-orange color) – collects where there is abrasion/ ulcer.
- slit lamp examination – only seen if abrasion is signif
- fundoscopy – loss/decreased red light reflex suggest major abrasion
Management of corneal abrasion.
red eye and threat to vision - same day opthal referral.
analgesia.
eye patch that seals lid.
cyclopentolate/ diclofenac drops to dilate pupil (reduces iris spasm).
Abx eye drops if needed
FOLLOW UP AFTER 24 HRS.
How are chemical eye burns treated?
check toxbase.
immediate eye irrigation w/ saline until pH returns to normal.
paracetamol (analgetic eye drops only to be used after irrigation).
cyclopentolate - dilate pupil and stop painful eye spasms.
topical Abx and corticosteroid if needed.
Define hyphema.
the collection of blood in the anterior chamber of the eye.
ant chamber = between cornea and iris.
the blood may cover part or all of the iris and the pupil. can partially or fully block vision.
mostly due to trauma, spontaneous hyphemas can occur in the setting of sickle cell disease or other increased bleeding states.
How do foreign bodies in the eye present?
- Red, watery eye.
- Painful
- Blurry vision (signif vision loss if body is intraocular).
- Hyphema
How is foreign body diagnosed?
- clinical
intraocular body – CT orbit
How are foreign bodies in eye managed?
- remove - numb w/anaesthetic eye drops, and fluorescein drops to use slit lamp to guide removal.
- iron and steel leave ring of rust - remove w/ sterile needle.
- sweep cotton wool inside of eye to collect tiny particles.
- intraoccular - Abx (IV or drops) and tetanus vaccine.
Causes of a conjunctival foreign body?
- dust or grit blown into eye via wind.
- fb gravitates into lower fornix - remove w/ cotton bud.
sub tarsal FB - presentation, diagnosis and Mx?
FB stuck in eyelid - pain on blinking.
Dx - Fluorescein staining may show vertical corneal abrasions ( ‘ice rink’).
Tx - ever eyelid and remove fB w/ cotton wool. Abx (chloramphenicol, fusidic eye drops).
Mx of corneal FB?
- remove w/ cotton wool first.
if fail - 23g needle. - Abx - patient to return is symp persist past 36hrs.
- Refer patients with large, deep or incompletely removed FB, or if a rust ring present.
Define blowout fracture?
- Break in 1 or more of the 7 bones that surround the eye.
Pathophysiology of blowout fracture?
- object strikes the eye - forces transmitted to orbit - bones break from pressure by force of trauma.
- herniation of contents into maxillary and ethmoid sinus.
