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Surgery12
Core notes
Question | Answer |
---|---|
Eye Penettating injury | no pain, lens,retina and vitreous have no nerve ending to conduct sensations of pain. immediate referral to opthalmology. |
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. |
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. |
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. |
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 |
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.... |
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 |