Ocular Trauma Flashcards Preview

Ophthalmology > Ocular Trauma > Flashcards

Flashcards in Ocular Trauma Deck (36):
1

Corneal Abrasions

Maybe patch?
Oral Pain meds
Prophylactic Abx
Check back in 24 hrs

2

Conjunctival Laceration

- May be isolated or part of other injuries.
- Ocular irritation, pain, foreign body sensation
- Chemosis, subC hemorrhage, torn conjunctiva

3

Conjunctival Lac Mgmt

Observation
Prophylactic topical Abx
Surgical repair for large lacerations

4

Corneal Lacerations

- If lac is through all layers of the cornea, it is an open globe injury.
- Cover eye with shield or cup
- NO pressure on eye
- Analgesics
- Lower IOP
- Td

5

Lid Lacerations

A laceration of the eyelid
Require eval for open globe injury
Look out for orbital fat prolapse

6

Full thickness lid laceration = ?

Immediate Ophtho consult

7

Foreign Body

Can remove with slit lamp and 18G needle
Rust ring will form within a day
Make sure no intraocular FB is present

8

Metal is toxic to ______?

Photoreceptors. Can destroy retinal cells.

9

Penetrating Trauma

Emergency Department Mgmt
Eye shield
NPO, optho referral
IV cephalosporin
CT, radiographs
DO NOT measure IOP

10

Intraocular FB

Metal on metal
Deep eye pain
Use CT scan

11

Hey pat, is an MRI a good method to detect an intraocular foreign body in a metalworker?

No, it will rip their eyes out and kill everyone in the whole world. This includes everyone you love, have ever loved and ever will love. All of the fluffy kittens and puppies and unicorns will also perish. Do not give this person an MRI.

12

Globe Rupture

A very serious situation where the outer integrity of the eye os disrupted by blunt or penetrating trauma.

13

Globe rupture mgmt

CT scan to RO entrapment
NPO
Td status
Emergent consult
IV analgesics, abx
Treat N/V aggressively
elevate head of bed

14

Orbital Wall Fx

- Blowout Fracture
- Orbital walls are thin and tend to fracture with blunt trauma.
- Common areas are medial wall and floor
- May entrap fat and muscles

15

Blowout Fx Eval

Visual Acuity, color testing
EOM check
Check for proptosis or ENopthalmos
Palpate for step offs and crepitous
Check facial sensation

16

Blowout Fx mgmt

CT scan
Refer to surgery
Abx (keflex, augmentin)

17

UV/Photokeratitis

Caused by UV radiation to the eyes
Recreational sun exposure
Sunlamps, tanning beds
Anything with UV radiation

18

UV keratitis Presentation

Photophobia, FB sensation, usually bilateral
Erythema of face and lids, decreased VA
NO discharge, hazy cornea, constricted pupils
VERY painful

19

UV keratitis Tx

Oral analgesics
Lubricating abx ointment
recheck in 1-2 days

20

Hyphema

Blood in the anterior chamber
Medical emergency
Check VA
Can result in permanent vision loss

21

Hyphema Emergency Mgmt

Assess primary injury
Manage IOP increases
Immediate referral

22

Hyphema Tx

Elevate head
Dilate pupil, eye patch
Control IOP (Timoptic, diamox)
IV mannitol

23

Which X-ray view should be obtained for a suspected blowout fx?

Waters View.

24

When should a hyphema be admitted (3 factors)?

- Anti-coagulated
- Decreased VA
- ED eval is greater than 1 day after injury

25

Is an alkali or acid burn generally worse?

Alkali is generally worse.

26

Chemical Burn

Requires immediate treatment
Copious irrigation
Assess ocular damage and manage accordingly

27

Continuous eye irrigation should be done for chemical burns until pH reaches ?

7.5 range.

28

Post-irrigation mgmt of chemical burns

Erythromycin
Cycloplegic if epithelial defect (cyclopentolate)
Optional eye patch if unilateral
Prompt optho consult

29

Traumatic Iritis

Inflammation of the iris (cell and flare)
Moderate blunt injury
Pain, blurred vision, HA, photophobia
Lid bruising/edema
Sluggish pupil
Optho consult!

30

Traumatic Iritis Tx

Usually resolves within a week
- Topical steroid
- Cycloplegic (cyclogyl) several times/day

31

Retrobulbar Hemorrhage

- Disruption and hemorrhage or posterior arterial supply.
- Trauma, surgery, infxn
- 24 hrs post-trauma

32

Retrobulbar Hemorrhage Presentation

Malposition of the eye
Increased IOP
Proptosis
Refer!

33

Preorbital (preseptal) cellulitis

Infxn of soft tissues anterior to orbit septum
Mild: rarely has complications

34

Orbital Cellulitis

Infection of the contents of the orbit (fat and muscles).
May cause loss of vision and fatality

35

Preorbital Cellulitis Tx

Consult optho and ENT
Outpatient if greater than a year old
Oral Abx (clindamycin or bactrim AND augmentil

36

Orbital Cellulitis Tx

Inpatient admission
IV Abx (Vanco and Ampicillin) for 2-3 weeks