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Opthalmic trauma pdf
- 1. A PRESENTATION BY THE CASUALTY CREW OPTHALMIC TRAUMA
- 3. CORNEAL ABRASION • DIFFICULT TO SEE • BE SUSPICIOUS WHEN PAIN DOES NOT MATCH WHAT YOU CAN SEE • NOTICE THE INJECTION OF VESSELS • IF YOU’RE NOT SURE IF ITS SERIOUS RATHER REFER TO OPHTHALMOLOGISTS
- 4. BLUE LIGHT AND STAINING THE SAME EYE THIS TIME IT STAINED WITH FLUORESCEIN MULTIPLE LINEAR ABRASIONS ABRASION MUCH EASIER TO SEE NOW
- 5. REMEMBER TO CHECK UNDER THE EYELID ❖ CAREFUL EXAMINATION WILL OFTEN SAVE YOU FROM UNNECESSARY BLUSHES LATER ON ❖ IF A FOREIGN BODY IS EMBEDDED DO NOT REMOVE IT YOURSELF BUT REFER
- 6. SUBCONJUNCTIVAL HAEMMORHAGE ❖ ARE BOTH OF THESE SUBCONJUNCTIVAL HAEMORRHAGES?
- 7. THIS IS A SUBCONJUNCTIVAL HAEMMORHAGE ❖ NOTICE THE FLAT NAURE ❖ BRIGHT RED ❖ OFTEN DUE TO TRIVIAL INJURY (COUGH , SNEEZE, MINOR TRAUMA) ❖ NO TX NEEDED ❖ REASSURE PT
- 8. THIS IS A BLOODY CHEMOSIS ❖ NOTICE THE SWELLING OF THE SCLERA ❖ THIS IS NORMALLY DUE TO TRAUMA ❖ HIGHLY SUSPICIOUS OF PENETRATING GLOBE TRAUMA ❖ IF NOT FROM TRAUMA MAY BE SIGN OF A COAGULOPATHY ❖ REQUIRES REFERRAL
- 9. FOREIGN BODIES ❖ MECHANISM OF INJURY VERY IMPORTANT ❖ IF YOU SUSPECT PENETRATING INJURY THEN YOU……….. ❖ DONT FORGET YOUR TETANUS PROPHYLAXIS ❖ DONT TRY AND REMOVE RUST RINGS RUST RING FROM FB
- 10. HYPHEMA BLOOD IN ANTERIOR CHAMBER ❖ YOU KNOW WHAT I’M GONNA SAY…………………………………. ❖ REFER REFER REFER!!!! ❖ THIS IS A RELATIVE EMERGENCY, SHOULD BE SEEN WITHIN 24 HRS 8 BALL HYPHEMA
- 11. DESCRIBE WHAT YOU SEE WHATS GOING ON HERE? ❖ THIS PT WAS WORKING WITH AN ANGLE GRINDER
- 12. INTRA-OCULAR FB ❖ MECHANISM OF INJURY IMPORTANT ❖ PAIN IS OFTEN NOT THAT SEVERE ❖ YOU NEED TO HAVE A HIGH INDEX OF SUSPICION ❖ AND THEN YOU………. NOTICE THE FB! NOTICE THE TEAR DROP PUPIL
- 13. AND WHAT IS THIS?
- 14. VERY EASY TO MISS !!! LENS DISLOCATION ❖ ALWAYS DO A CAREFUL EXAMINATION ❖ CURSORY GLANCES AT THE EYE WONT REVEAL MUCH ❖ PT WILL COMPLAIN OF VISUAL DISTURBANCES ❖ LOOKS LIKE YOU SHOULD MEMORIZE THE EYE CLINIC SPEED DIAL!!!! LENS
- 15. WHAT DO WE DO IN CASUALTY? IRIODIALYSIS ❖ THE IRIS IS PULLED AWAY FROM THE CILLIARY BODY ❖ PT WILL COMPLAIN OF VISUAL DISTURBANCES AND A DOUBLE PUPIL
- 16. WHAT DO YOU SEE?
- 19. DESCRIBE THESE INJURIES BLOODY CHEMOSIS UPPER LID MEDIAL CANTHUS LACRIMAL DUCT GLOBE RUPTURE 8 BALL HYPHEMA LAT CANTHUS OPEN GLOBE TEAR DROP PUPIL HYPHEMA SUBCONJ HAEM IRIS HERNIATION CORNEAL OEDEMA
- 20. EYELID ANATOMY
- 21. EYELID TRAUMA LACRMAL SAC AND DUCT NEEDS ANATOMIC REPAIR DESCRIBE WHAT YOU SEE DESCRIBE
- 22. SO WHAT DO YOU DO WITH THESE INJURIES IN CASUALTY?
- 23. WE REFER BECAUSE WE MAY DO MORE HARM THAN GOOD THIS REPAIR LOOKS REASONABLE BUT THE PT SUFFERED LONG TERM CONTRACTURES, EYELID RETRACTION LAGOPHTALMOS
- 24. DESCRIBE WHAT YOU SEE
- 26. BLOODY CHEMOSIS SUSPECTED LENS DIXLOCATION SMALL HYPHEMA INFERIOR LID INJURY LACRIMAL DUCT/SAC INJURY SUP LID INJURY GLOBE RUPTURE IRIS HERNIATION EXTRUSION OF ORBITAL CONTENTS LATERAL CANTHUS INJURY