Ocular Trauma Flashcards
What is the important information that should be obtained from a history of a patient coming in with ocular trauma?
What happened:
Physical, chemical, thermal.
Nature and size of object: sharp or blunt.
Speed of impact.
Possible foreign body (on the surface or penetrating).
When it happened?
Symptoms? (always compare acuity to a baseline)
Previous treatment?
PMH etc..
Define the following terms of ocular trauma: eyewall, closed globe injury, contusion, lamellar laceration, open globe injury, laceration, rupture, penetrating injury, perforating injury.
Eyewall: sclera and cornea
Closed globe injury: eyewall does not have a full thickness wound
Open globe injury: eyewall has a full thickness wound
Closed globe injuries:
Contusion: Rupture of capillaries (bruise) usually sue to blunt trauma.
Lamellar laceration: a partial thickness wound of part of the eyewall.
Open globe injuries:
Laceration: Full thickness wound of part of the eyewall due to a sharp object.
Rupture: Full thickness wound of the eyewall sue increased IOP.
Penetrating injury: an injury in which an object enters the eye but does not come out the other end.
Perforating injury: an injury in which an object goes straight through the eye. You can have a cornealor a whole globe perforating injury.
Describe the examination and investigations for a patient coming in with ocular trauma?
Examination:
Assess acuity.
Look in the eye for signs of disease.
If signs of a penetrating globe injury are suspected or seen, do not manipulate, touch or patch the eye, make the patient nil by mouth and refer for surgery.
If a ocular fracture is suspected or a foreign body which cannot be seen is suspected the next investigation should be a CT scan.
