Core notes
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Eye Penettating injury | no pain, lens,retina and vitreous have no nerve ending to conduct sensations of pain.
immediate referral to opthalmology.
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| Corneal abrasion (non-penetrating injury) | heal v. quickly, and may conceal a penetrating injury.
3% of all ED cases: important to exclude a penetrating injury. ?high veocity injury?
Presentaion: excruciating pain and and an inability to open eye due to foreign body sensation.
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| high velocity eye injury | a penetrating injury must be excluded. symptoms include distortion of the pupil (tear drop shape, dark tissue in the cornea or sclera, vitreous haemorrhage and hyphema.
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| flourescein staining | corneal abrasions, a stained abrasion can often be seen as yellowish with the naked eye, it is as important to evert the upper lid to exclude a foreign body where they often become lodged and cause abrasions.
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| management of a penetrating injury | immediate referral to an opthalogist
xray or CT scan of the orbait to check for foreign bodies
a patch or ointment is not advisiable
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| Foreign body treatment | local
if loose, stream of irrigating solution.
adherent: gently roll cotton bud across the globe to pick it up.
remove under magnificatio using sharper.
"rust ring" may occur
then after treat as abrasion....
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| Corneal abrasion treatment | antibiotic drops (chloramphenicol)
cycloplegic agents (homatrophine 2%) provides pain relief by dilation.
topical NSAIDS
avoid eye rubbing/pressing
>3mm get them back, otherwise they usually heal up nicely and do not require follow up.
recurrent er
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thoem213
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