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BLUNT OCULAR TRAUMA

BLUNT OCULAR TRAUMA. Dr Soujanya K. general rule. anterior segment, or the posterior half is preferentially affected. Delayed or progressive changes: in some cases Guarded visual prognosis for all cases Review for months to years. Mechanics of concussion injuries. Coup or Direct damage.

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BLUNT OCULAR TRAUMA

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  1. BLUNT OCULAR TRAUMA Dr Soujanya K

  2. general rule anterior segment, or the posterior half is preferentially affected.

  3. Delayed or progressive changes: in some cases • Guarded visual prognosis for all cases • Review for months to years

  4. Mechanics of concussion injuries

  5. Coup or Direct damage max. damage at the site of impact

  6. Contre-coup damage max. damage at a point distant from the actual site of impact

  7. Blunt injury Mechanism of injury Dr UmaKulkarni

  8. Blunt injury Mechanism of injury Dr UmaKulkarni

  9. Blunt injury Inside-out injury Mechanism of injury Dr UmaKulkarni

  10. A, direct impact; B, compression wave force; C, reflected compression wave; D, rebound compression wave.

  11. subconjunctivalhaemorrhage: no treatment.

  12. CORNEA Abration > distortion of corneal reflex > flouresceinstain > acute pain & lacrimation

  13. RECURRENT EROSIONS -Spontaneous or injury with babies’ fingernails. -Heals and recurs after days,weeks or months. - occurs on waking up in the morning - Epithelium loosely attached to the Bowmans membrane

  14. Treatment >Debridethe loose epithelium and > pad the eye for 48hrs or bandage soft contact lens.

  15. Anterior chamber

  16. Hyphema

  17. Blood Staining Of Cornea

  18. Blood Staining Of Cornea >colourdep [reddish brown or greenish ]-On duration >clears slowly from periphery

  19. CORNEAL OPACITY • Stromal edema • DM folds Stromal edema, DM Folds DM Tear

  20. Sclera • Partial thickness scleral wounds (lamellar scleral lacerations)

  21. Iris Traumatic miosis

  22. TRAUMATIC MYDRIASIS Large and immobile pupil minute ruptures in the pupillary margin

  23. Iridodialysis

  24. IRIDODIALYSIS • Black biconvex area at the periphery • D shaped pupil • Distant direct O’scopy- red glow in the periphery • Zonules may also be seen • Monocular Diplopia is a common complaint

  25. Traumatic Aniridia / Irideramia

  26. ANTEFLEXION OF THE IRIS Pigmented back of the iris faces forwards

  27. Retroflexion of the iris • Whole of the iris is doubled back into the ciliary region and becomes invisible.

  28. Aniridia Implants

  29. ANGLE RECESSION GLAUCOMA • Traumatic secondary open angle glaucoma • The ciliary body is torn- • longitudinal muscle remains attached to the spur at its insertion • circular muscle, pars plicata and the iris root are displaced posteriorly

  30. Clinical features • Unilaterally raised IOP • Abnormally deep AC in the involved meridian • Hyhaema • Gonioscopy- Irregularly broad CB bandassociated with changes of optic neuropathy.

  31. IRREGULAR BROADENING OF CB BAND

  32. Vosius Ring

  33. Circular ring of brown pigment –on ant. capsule. • Due to striking of the contracted pupillary margin against the crystalline lens. • It is always smaller than the size of the pupil.

  34. Concussion cataract • Imbibition of aqueous • Direct mechanical

  35. Early Rosette Cataract Feathery lines of opacities along the star-shaped suture lines; usually in the posterior cortex

  36. LATE ROSETTE CATARACT • Posterior cortex, 1 to 2 years after the injury. • Its sutural extensions are shorter and more compact

  37. TOTAL TRAUMATIC CATARACT

  38. Discrete subepithelial opacities • Traumatic zonular cataract. • Early maturation of senile cataract • Traumatic absorption of the lens

  39. TRAUMATIC SUBLUXATION & DISLOCATION OF LENS

  40. TRAUMATIC SUBLUXATION OF LENS

  41. LENS SUBLUXATION

  42. ANTERIOR DISLOCATION OF LENS

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