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Ocular Trauma & Emergencies. Sam Alexander, MD. Eye Trauma: Incidence. 1.3 million eye injuries per year in the United States 40,000 of these injuries lead to visual loss. The History: Vision. Are one or both eyes affected? Vision at time of examination? Vision prior to trauma?. - PowerPoint PPT Presentation
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Sam Alexander, MD
Ocular Trauma &
Emergencies
1.3 million eye injuries per year in the United States
40,000 of these injuries lead to visual loss
Eye Trauma: Incidence
Are one or both eyes affected?Vision at time of examination?Vision prior to trauma?
The History: Vision
Symptoms besides decreased vision?Duration of symptoms?Any surgery prior to trauma?
The History: Symptoms
Are one or both eyes affected?Vision at time of examination?Vision prior to trauma?
The History: Vision
Complete Eye ExaminationVision
External exam
Pupils
Motility exam
Anterior segment
Ophthalmoscopy
Pressure
Visual fields
A true ocular emergencyAlkali more serious than acidImmediate irrigation essential
Chemical Burns
Irrigation of chemical burns should be initiated before arrival
at emergency center.
Topical anesthesiaCopious irrigationCheck for foreign bodies
Chemical Burns: Initial EC Management
Topical cycloplegicTopical antibioticPatch eyePrompt referral to ophthalmologist
Chemical Burns: EC Treatment Following Irrigation
Assume globe is rupturedShield eye and refer to ophthalmologist25% of patients have other ocular injuries
Management of Hyphema
Surgery indicated only for persistent diplopia or poor cosmesis
Surgery can be delayed since diplopia may be transient
Orbital Trauma: Isolated Blow-Out Fractures
Avoid lid margin retractionGive tetanus prophylaxisRemove superficial foreign bodiesRule out deeper foreign bodies
Superficial Lid Lacerations
Foreign body sensationPainTearingPhotophobia
Corneal Abrasions: Symptoms
Topical cycloplegicTopical antibiotic
Corneal Abrasions: Treatment
Thank You!
Questions?