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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

Ocular Trauma

Sandra M. Brown, MD

Associate Professor

Ophthalmology and Visual Sciences

nature of injury
Nature of Injury
  • Blunt
  • Lacerating
  • Chemical
blunt trauma
Blunt Trauma
  • Mild – moderate
    • “bruise” ocular tissues
    • Eye wall intact
  • Moderate – severe
    • Rupture eye wall
    • Very severe consequences
lacerating trauma
Lacerating Trauma
  • “cut” eye wall
  • Outcome depends on extent and location
location of injury
Location of Injury
  • Anterior Segment
  • Posterior Segment
  • Adnexa
  • Orbital Structures
anterior segment
Anterior Segment
  • Conjunctiva
  • Cornea
  • Iris
  • Lens
posterior segment
Posterior Segment
  • Vitreous
  • Retina
  • Optic nerve
adnexa
Adnexa
  • Eyelids
  • Lacrimal Structures
orbital structures
Orbital Structures
  • Extraocular muscles
  • Bony walls
disgusting photographs
Disgusting Photographs
  • Front to back…
common minor eye injuries
Common Minor Eye Injuries
  • Corneal abrasion
  • Corneal foreign body
  • Chemical splash
  • Traumatic iritis
diagnosis
Diagnosis
  • History
    • Sharp vs blunt vs chemical injury
  • Exam
    • CHECK VISION
    • CHECK VISION
    • CHECK VISION
diagnosis cont
Diagnosis cont.
  • Exam – Pry lids apart!
    • Cornea clear?
    • Pupil round?
    • Pupil black?
    • Blood clotted behind cornea?
diagnosis cont1
Diagnosis cont.
  • Exam
    • Red reflex?
    • Eyes move symmetrically?
fluorescein test
Fluorescein Test
  • Topical “eye dye”
  • COBALT light
abrasion treatment
Abrasion Treatment
  • Erythromycin ointment
  • +/- patch
  • 1-2 day follow-up with eye doc
foreign body treatment
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
chemical treatment
Chemical Treatment
  • IRRIGATE
  • Check pH
  • Minor
    • E-mycin ointment
    • 1 day follow-up eye doc
  • Major
    • Same day eval by eye doc
traumatic iritis
Traumatic Iritis
  • Moderate blunt injury
  • Photophobia
  • Lid bruising/edema
  • Subconj heme or injection
  • Pupil sluggish
  • Eval by eye doc
please do not confuse
Please Do Not Confuse
  • Subconjunctival hemorrhage
  • Hyphema