Ocular emergencies

Question 1

Corneal abrasion- Eti

Answer 1

Scratch of cornea

- Fingernail, paper, contacts

Question 2

Corneal abrasion- Sx

Answer 2

• Severe pain

- Photophobia

Question 3

Corneal abrasion- Dx

Answer 3

• Fluorescein

- RO foregin body

Question 4

Corneal abrasion- Tx

Answer 4

• Bacitracin ointment

Question 5

Temporal arteritis- Eti

Answer 5

• Systemic inflammation of medium & large vessels
• Pts > 50-65
• Assoc with polymyalgia

Question 6

Temporal arteritis- Sx

Answer 6

• Jaw claudication
• HA, scalp tenderness
• Diplopia & monocular loss of vision

Question 7

Temporal arteritis- Dx

Answer 7

• ESR increased

Question 8

Temporal arteritis-Tx

Answer 8

Prednisone

Question 9

Thermal burns- Eti

Answer 9

Thermal- Burn to lids, cornea & conjuntiva

Chemical- Acid or alkali, work related

Question 10

Thermal burns- Sx

Answer 10

Thermal- Hyperemia- engorgement and increase in flow to vessels.
- Necrosis, edema & corneal haze
Chemical- Alkali more serious. Diffuse edema, ulcerations

Question 11

Thermal burns- Tx

Answer 11

Thermal- Anesthetic, mydriatic agent. Good prog.

Chemical- Copious irrigation, buffering

Question 12

Amaurosis fugax- Eti

Answer 12

• Transient monocular blindness

- Retinal emboli, occlsion, optic disc swelling

Question 13

Amaurosis fugax- Sx

Answer 13

• Monocular loss of vision with complete recovery within mins
• Curtain effect- curtain passing across visual filed

Question 14

Amaurosis fugax- Dx

Answer 14

• Tx underlying cause

- CCB, ASA

Question 15

Corneal/ conjunctival foreign body- Eti

Answer 15

• Foreign body in eye

Question 16

Corneal/ conjunctival foreign body- Sx

Answer 16

• Have something in eye
• Consistant hx
• present on cornea or upper lid
• Rust ring if steel

Question 17

Corneal/ conjunctival foreign body- Dx

Answer 17

• Test visual acuity

- Sterile flourescein

Question 18

Corneal/ conjunctival foreign body- Tx

Answer 18

• Remove with sterile, wet application
• Bacitracin
• No eye-patch
• Steel- Excise affected tissue

Question 19

Ocular trauma/ globe rupture- Eti

Answer 19

• Leading cause of monocular blindness
• Any type of trauma to orbit
• Forceful blow or corneal laceration

Question 20

Ocular trauma/ globe rupture- Sx

Answer 20

• Irregular, displaced pupol
• Hyphema
• Contents spilling from globe
• Flattened anterior chamber

Question 21

Ocular trauma/ globe rupture- Tx

Answer 21

• Light bandage & rigid shield
• Analgesics & abx
• Antiemetics

Question 22

Intraocular foreign body- Eti

Answer 22

• Grinding or hammering
• Into eye through cornea
• Increased risk of intraocular infection

Question 23

Intraocular foreign body- Sx

Answer 23

• Something hit eye

- marked loss in vision, opacity

Question 24

Intraocular foreign body- Tx

Answer 24

• Abx, mydriatic, analgesics

Question 25

Traumatic iritis/ Anterior Uveitis- Eti

Answer 25

- Autoimmune associated - Trauma - Intraocular inflammation of iris

Question 26

Traumatic iritis/ Anterior Uveitis-Sx

Answer 26

- Photophobia - Pain - Distorded, miotic pupil - Inflammatory cells and redness

Question 27

Traumatic iritis/ Anterior Uveitis-Tx

Answer 27

- Mydriatic agents | - Steroids

Question 28

Orbital fracture- Eti

Answer 28

Fracture of orbital floor

Question 29

Orbital fracture- Sx

Answer 29

- Enopthalmos - Hypotropia ( eye displaced downward) - Diplopia - Limited upward EOM - Decreased sensation over maxilla

Question 30

Orbital fracture- Tx

Answer 30

Analgesics, abx, eye patch

Question 31

Orbital Cellulitis- Eti

Answer 31

- S. pneumo or H flu infection of paranasal sinus

Question 32

Orbital Cellulitis- Sx

Answer 32

- Proptosis - Restricted EOMs - Swelling and lid redness - Fever

Question 33

Orbital Cellulitis- Tx

Answer 33

IV abx- prevent optic neuritis | - Penicillin

Question 34

Orbital palsy- Eti

Answer 34

- Intracranial or intraoribal lesion - Myasthnia gravis - Graves - CN 6- Intracranial pressure

Question 35

Orbital palsy- CN 3- Sx

Answer 35

- Ptosis - Depressed eye - Dosent contract to light - Lateral EOM intact, all others off

Question 36

Orbital palsy- CN 4- Sx

Answer 36

Upward deviation of eye

Question 37

Orbital palsy- CN 6- Sx

Answer 37

- Convergent squint - Failure of ABduction - Diplopia

Question 38

Orbital palsy-Dx/Tx

Answer 38

- MRI | - Refer

Question 39

Periorbital contusion- Eti

Answer 39

- Contusion injury to eye and surrounding structures

Question 40

Periorbital contusion- Sx

Answer 40

- Ecchymosis | - Lots of complications

Question 41

Periorbital contusion- Tx

Answer 41

- Refer | - Danger of secondary hemorrhage- no aspirin