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Lecture for Medical Students

Lecture for Medical Students. Dr. Nizamuddin MD, FRCS Vitreo-Retinal Surgeon King Abdul Aziz University Hospital, Jeddah. Ocular Injuries. Objective. A primary care physician is expected to evaluate the common ocular injuries recognize which problems are emergent / urgent and to

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Lecture for Medical Students

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  1. Lecture for Medical Students Dr. Nizamuddin MD, FRCS Vitreo-Retinal Surgeon King Abdul Aziz University Hospital, Jeddah

  2. Ocular Injuries

  3. Objective • A primary care physician is expected to • evaluate the common ocular injuries • recognize which problems are emergent / urgent and to • Manage them accordingly

  4. Ocular Injuries • 30%- 50% of all eye emergency Cases • Half a million blinding injuries occur every year • Commonest cause of unilateral blindness • Affect Young Males

  5. Ocular Injuries • Evaluation of Injured Eye • Classification of Ocular Injuries • Management

  6. Preview • Evaluation of Ocular Trauma • History • Inspection • Visual Acuity • Pupil • Slit lamp /Torch light examination • Fundoscopy • Extra-ocular Motility

  7. History • Age, occupation • Brief history of Injury- • Type of traumatic event- ?accident / assault • Time of onset • Type of injury- Blunt or sharp object / Acid or Alkali • Specific symptoms – pain / decreased vision • Prior condition of eyes • Past medical history, medications, allergies ,Tetanus. You should not delay prompt treatment for the sake of detailed history- especially in chemical injury

  8. Inspection • Inspect the eye lids • Always be conscious of possible injury to multiple tissues • Be extremely gentle • Do not put pressure on a traumatized eye

  9. Inspection • If you suspect a globe rupture at any point of the examination • Stop • Protect eye – Eye Sheild

  10. Inspection –contd.. • Call ophthalmology on-call • NPO, IV -Antibiotics

  11. Visual Acuity • Check eye individually • Snellens chart - if not available Finger counting • If vision poorer – Hand movements / response to light • PL-perception of light • PR-projection of light

  12. Pupil examination • No RAPD with diminished vision • Hyphema • Cataract • Vitreous hemorrhage Normal • RAPD • Retinal detachment • Optic Nerve damage RAPD

  13. Anterior Segment • Perform slit lamp Examination • If not available, use ophthalmoscope • Inspect • Conjunctiva • Cornea • Anterior chamber • Iris • Lens 

  14. Anterior Segment Corneal foreign body Fluorescein helps to detect corneal epithelial defects

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