Sympathetic Ophthalmia

Question 1

Rare but devastating bilateral granulomatous uveitis that comes on 10 days to many years following a perforating eye injury

Answer 1

Sympathetic Ophthalmia

Question 2

Cause is unkown

Answer 2

Sympathetic Ophthalmia

Question 3

Probably related to hypersensitivity to some element of pigment bearing cells in the uvea

Answer 3

Sympathetic Ophthalmia

Question 4

The injured or exciting eye becomes inflamed first and the fellow eye secondarily

Answer 4

Sympathetic Ophthalmia

Question 5

Signs and symptoms of Sympathetic Ophthalmia

Answer 5

Photophobia
Redness
Blurred vision
Floaters
Diffuse uveitis with presence of exudates in the retina

Question 6

Treatment of Sympathetic Ophthalmia

Answer 6

Enucleation of severed injured sightless eye within 10 days after injury

Question 7

Typically follows penetrating trauma

Answer 7

Sympathetic Ophthalmia

Question 8

Bikateral granulomatous panuveits

Answer 8

Sympathetic Ophthalmia

Question 9

Granulomatous anterior uveitis

Answer 9

Sympathetic Ophthalmia

Question 10

Multifocal choroiditis

Answer 10

Sympathetic Ophthalmia

Question 11

___ burns more common and worse than ___ burns

Answer 11

Alkali ; acid

Question 12

saponification

Answer 12

Alkali

Question 13

Denatures collagen, thromboses vessels

Answer 13

Alkali

Question 14

Household cleaners, fertilizers, drain cleaners

Answer 14

Alkali

Question 15

Coagulation

Answer 15

Acid

Question 16

H+ precipitates protein- barrier

Answer 16

Acid

Question 17

Industrial cleaners, batteries, vegetable preservatives

Answer 17

Acid

Question 18

All chemical injuries should be treated as ____

Answer 18

Ocular emergency

Question 19

Immediate ___ should be started at the site of injury before the patient is transported

Answer 19

tap water lavage

Question 20

dissociate into hydrogen ions and anions in the cornea

Answer 20

Acid

Question 21

The H molecule damages the ocular surface by altering the pH, while the anion causes protein denaturation, precipitation and coagulation

Answer 21

Acid

Question 22

Protein coagulation generally prevents deeper penetration or acids and is responsible for the ground glass appearance or the corneal stroma acid injury.

Answer 22

Acid

Question 23

examples of acid

Answer 23

Sulfuric acid
Hydrochloric acid
Nitric acetic chromic acid
Glass polish
Vinegar

Question 24

Lipophilic, penetrate tissues more rapidly than acids

Answer 24

Alkali

Question 25

They saponify fatty acids of cell membranes, penetrate corneal stroma and destroy proteoglucan ground substance and collagen bundles

Answer 25

Alkali

Question 26

This interactions facilitate deeper penetration into the cornea and into the anterior segment

Answer 26

Alkali

Question 27

Alkali substance dissociate into a ___ and a cation in the ocular surface

Answer 27

Hydroxyl ion

Question 28

Saponifies cell membrane fatty acids

Answer 28

Hydroxyl ion

Question 29

Interacts with the stromal collagen and glycosaminoalgycans

Answer 29

Cation

Question 30

Subsequent hydration of glucosaminoglycans results in __

Answer 30

Stromal haze

Question 31

Causes fibril distortion and shortening leading to trabecular meashwork alterations that cause inc. IOP

Answer 31

Collagen hydration

Question 32

Alkaline chemicals contain

Answer 32

Ammonium hydroxide K sodium magnesium calcium hydroxide

Question 33

Alkali rapidly penetrates through ocular tissues

Answer 33

Chemical reaction on ocular tissues

Question 34

Acids form a barrier of precipitated necrotic tissue that tends to limit further penetration and damage

Answer 34

Chemical reaction on ocular tissues

Question 35

Clear cornea Limbal ischaemia- nil

Answer 35

Grade 1 excellent prognosis

Question 36

Cornea hazy but visible iris details Limbal ischaemia < 1/3

Answer 36

Grade 2 good prognosis

Question 37

No iris details Limbal ischaemia- 1/3 to 1/2

Answer 37

Grade 3 guarded prognosis

Question 38

Opaque cornea Limbal ishchaemia > 1/2

Answer 38

Grade 4 very poor prognosis

Question 39

Initial treatment chemical burns

Answer 39

Immediate copious irrigation Topical anesthesia (tetracaine)

Question 40

In the ER, irrigation of the ocular surfaces and conjunctival fornices should be done using __

Answer 40

Streile saline solution using IV tubing