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Flashcards in VII Deck (68):
1

Flat anterior chamber = ?

Loss of aqueous humor

2

What may happen to the iris with trauma?

Plug, iritis, hyphema

3

Is a TDaP needed post ocular trauma?

Yes

4

Hammering on metal = ?

Intraocular FB

5

H/o grinding things = ?

Corneal FB

6

H/o welding = ?

Corneal UV burn

7

h/o racquet sports = ?

Hyphema

8

H/o fist fights = ?

-Hyphema
-BOF
-ruptured globe

9

What are the basic exam bits with ocular trauma?

-VA
-External exam
-Pupils
-Motility exam
-Anterior segment
-Ophthalmoscopy

10

What are the two true ocular emergencies?

Chemical burns
CRAO

11

What are the two semi urgent ocular problems?

-Orbital fractures
-Subconjunctival hemorrhages

12

Which is more serious: alkali or acid burns to the eye?

Alkali

13

What is the immediate treatment for chemical burns?

Immediate irrigation

14

A lack of redness in the eye with chemical burns = ?

Ischemic Necrosis and badness

15

Corneal epithelium is derived from what?

Specialized area of the conjunctiva, that dedifferentiate, migrate centrally.

16

After irrigation, what are the three next steps in the care of chemical burns to the eye?

-Instill topical anesthetic
-Check for FBs
-Institute copious irrigation

17

What (general) amount of fluid is needed for irrigation of the eye? What type of fluid should be used to irrigate?

Liters
Anything

18

What topical agent should be used for chemical burns?

Cycloplegic agent and topical abx

19

Which is an immune privileged site: cornea or conjunctiva?

Cornea

20

What are the s/sx of corneal abrasion?

-FB sensation
-Pain
-Tearing
-Photophobia

21

What is the classic mimic of corneal abrasions?

HSV

22

How do you treat a corneal abrasion?

-Topical abx solution and topical NSAIDs (ketorolac)

23

What is the role of oral analgesics with corneal abrasions?

Ineffective

24

What is the role of prescribing topical abx for corneal abrasions?

Prophylaxis for infection of the eye

25

When should f/u be done with corneal abrasions?

24 hours

26

When should corneal abrasions be referred to an ophthalmologist?

-Not healed in 24 hours
-Abrasion related to contact lens wear
-White corneal infiltrate

27

When should patches NOT be used for corneal abrasions? (3)

-Contact lens wearers
-Dendritic or stellate epithelial defects
-Poor historians

28

What is acanthamoeba?

Keratitis (or encephalitis) causing parasite, often found in contact lens wearers

29

Why are topical anesthetic prescriptions contraindicated with corneal ulcerations?

Corneal toxicity

30

What must be done with rust rings?

Must be taken out in a few days, o/w will not heal

31

Pooling of the aqueous humor =? What should be done?

Full penetration or the cornea

Shield the eye and refer

32

What is the best imaging modality for FB in the eye?

head CT

33

True or false: hyphemas should always be assumed as a globe rupture, and be referred

True

34

What are the complications from hyphemas? (2)

-Rebleeding into the anterior chamber
-Glaucoma

35

If the globe is ruptured, what should be done?

Stop exam, shield eye, give TDaP, and refer immediately

36

How do you treat proptosis of the eye 2/2 severe orbital hemorrhage?

Decreased the pressure behind the eye

37

What can severe orbital hemorrhage lead to?

-Blindness 2/2 increase IOP

38

What are the complications from severe orbital hemorrhage?

-Bullous subconjunctival hemorrhage
-Proptosis
-Corneal exposure

39

What is the treatment for severe orbital hemorrhage?

Emergent lateral canthotomy

40

What is an Emergent lateral canthotomy?

Cutting the canthus to relieve pressure in the eye

41

What are the s/sx of orbital fractures? (4)

-Periorbital edema
-Ecchymosis
-Diplopia
-SQ emphysema

42

What can cause the numbness down to the cheek with orbital fracture?

Irritation from V2

43

What are the two indications for surgery 2/2 orbital fracture?

-Persistent diplopia
-Poor cosmesis (enophthalmos)

44

What is a blow-out fracture?

Muscles extend into the maxillary sinus

45

Young children under 15 need to be fixed within what timeframe? Why?

3-5 days
Need to reduce the scarring and inflammation that occurs. O/w interferes with development

46

Why should you avoid lid retraction with superficial lid lacerations?

Will have tearing their entire lives if tear ducts are involved

47

What should be done to treat superficial lid lacs (3)?

-Remove superficial FBs
-R/o deeper FBs
-Give TDaP

48

Should you debride tissue with dog bites in the eye?

No--want plastic surgeon to do it

49

What can cause UV keratitis?

-Welder's burn
-Snow blindness

50

What is UV keratitis?

UV rays irritate the superficial corneal epithelium, causing inhibition of mitosis, production of nuclear fragmentation, and loosening of the epithelial layer

51

What are the s/sx of UV keratitis?

-Photophobia
-FB sensation
-Tearing
-Pain

52

What is the treatment fro UV keratitis? (2)

-Cycloplegics
-analgesics

53

What usually causes traumatic optic neuropathy?

Damage to the head to directly to the orbit

54

What are the direct causes of traumatic optic neuropathy?

Lac of the ON, intraorbital hemorrhage

55

What are the indirect causes of traumatic optic neuropathy?

Shear forces on nerve or vascular supply

56

What are the s/sx of traumatic optic neuropathy? (2)

Visual loss is severe and immediate

RAPD

57

What is the treatment for traumatic optic neuropathy?

-Orbital or cranial surgery
-Therapy for indirect traumatic ON

58

What is the general treatment for corneal abrasions?

-Topical cycloplegics
-Topical abx ointment

59

White corneal infiltrate around abrasion = ?

It's not a corneal abrasion--it's an ulcer

60

When should ER docs not take out a FB in the eye?

If it is near the pupil or an area that the pupil will cover with dilation

61

What happens can happen to the retina with blunt trauma?

Cracking of the retina, and exposure of the choroid

62

Cherry red spot on fundoscopic exam = ?

CRAO

63

What is the relative platelet count with anterior ischemic optic neuropathy?

Elevated

64

What are the two treatments that must be done with suspected anterior ischemic optic neuropathy?

IV steroids
Obtain temporal artery bx

65

Teardrop pupil and flat A/c = ?

Penetrating injury

66

True or false: you should avoid digital palpation of a traumatic eye

True

67

What must be r/o with FB to the eye before getting an MRI?

Metal FB

68

What are the indication for prescribing a topical anesthetic?

NEVER