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Core notes

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
Created by: thoem213