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Ocular Trauma

Ocular Trauma. Sandra M. Brown, MD Associate Professor Ophthalmology and Visual Sciences. Nature of Injury. Blunt Lacerating Chemical. Blunt Trauma. Mild – moderate “bruise” ocular tissues Eye wall intact Moderate – severe Rupture eye wall Very severe consequences. Lacerating Trauma.

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Ocular Trauma

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  1. Ocular Trauma Sandra M. Brown, MD Associate Professor Ophthalmology and Visual Sciences

  2. Nature of Injury • Blunt • Lacerating • Chemical

  3. Blunt Trauma • Mild – moderate • “bruise” ocular tissues • Eye wall intact • Moderate – severe • Rupture eye wall • Very severe consequences

  4. Lacerating Trauma • “cut” eye wall • Outcome depends on extent and location

  5. Location of Injury • Anterior Segment • Posterior Segment • Adnexa • Orbital Structures

  6. Anterior Segment • Conjunctiva • Cornea • Iris • Lens

  7. Posterior Segment • Vitreous • Retina • Optic nerve

  8. Adnexa • Eyelids • Lacrimal Structures

  9. Orbital Structures • Extraocular muscles • Bony walls

  10. Disgusting Photographs • Front to back…

  11. Racoon Eye

  12. Lid Laceration

  13. Subconjunctival Hemorrhage

  14. Corneal Foreign Body

  15. Corneal Abrasion

  16. Curling Iron Burn

  17. Corneal Laceration

  18. Iris Sphincter Rupture

  19. Hyphema

  20. Traumatic Cataract

  21. Vitreous Hemorrhage

  22. Retinal Hemorrhage

  23. Optic Disc Hemorrhage

  24. Orbital Wall Fracture

  25. Common Minor Eye Injuries • Corneal abrasion • Corneal foreign body • Chemical splash • Traumatic iritis

  26. Diagnosis • History • Sharp vs blunt vs chemical injury • Exam • CHECK VISION • CHECK VISION • CHECK VISION

  27. Diagnosis cont. • Exam – Pry lids apart! • Cornea clear? • Pupil round? • Pupil black? • Blood clotted behind cornea?

  28. Diagnosis cont. • Exam • Red reflex? • Eyes move symmetrically?

  29. Fluorescein Test • Topical “eye dye” • COBALT light

  30. Corneal Abrasion

  31. Abrasion Treatment • Erythromycin ointment • +/- patch • 1-2 day follow-up with eye doc

  32. Corneal Foreign Body

  33. Foreign Body Treatment • Anesthetize eye • Remove FB • Cotton swab (don’t worsen abrasion!) • Kimura spatula • +/- needle tip • E-mycin and +/- patch • 1-2 day follow-up with eye doc

  34. Chemical Splash

  35. Chemical Treatment • IRRIGATE • Check pH • Minor • E-mycin ointment • 1 day follow-up eye doc • Major • Same day eval by eye doc

  36. Traumatic Iritis • Moderate blunt injury • Photophobia • Lid bruising/edema • Subconj heme or injection • Pupil sluggish • Eval by eye doc

  37. Please Do Not Confuse • Subconjunctival hemorrhage • Hyphema

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