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Eye Injury Assessment

Eye Injury Assessment. Chapter 16, p. 567. Clinical Anatomy-- p.567. Bony anatomy orbital frontal bone zygomatic bone The Eye globe conjunctiva cornea lens retina. Clinical Anatomy-- p.570. Muscular anatomy--fig. 16-4 rectus group oblique group. Visual Acuity-- p. 570.

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Eye Injury Assessment

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  1. Eye Injury Assessment Chapter 16, p. 567

  2. Clinical Anatomy--p.567 • Bony anatomy • orbital • frontal bone • zygomatic bone • The Eye • globe • conjunctiva • cornea • lens • retina

  3. Clinical Anatomy--p.570 • Muscular anatomy--fig. 16-4 • rectus group • oblique group

  4. Visual Acuity--p. 570 • Snellen chart • Acuity: • Emmetropia--20/20 • Myopia--near-sighted • Hypermetropia--far-sighted • Diplopia

  5. Injury Assessment: History--p.570 • Location of pain (globe, lid, etc) • Injury Mechanism (laceration, trauma, irritant) • Foreign objects(?)--sand, fingers, sweat, etc. • Prior visual records • corrected/uncorrected vision?

  6. Injury Assessment: Observation--p.572 • Nystagmus • Deformity-- • bony or soft tissue derangement • periorbital discoloration--orbital hematoma (Black Eye) • Symmetry--globe placement (pupils)

  7. Observation-- • eyelids p.572 • signs of infection: • stye • chalazion • symmetry (resting and active) • cornea-- • discoloration • hyphema--p.573

  8. Observation--p.573 • conjunctiva-- • conjunctivitis (pinkeye) • subconjunctival hemorrhage(p574-fig.16-9) • pupil-- • symmetry (anisocoria) • size & placement • shape (round) • reaction (PEARL)

  9. Pathologies- • Blow-out fracture • Corneal abrasion • Iritis • Detached retina • Conjunctivitis • Foreign Bodies

  10. Blow-out fracture-p.576 • Table-16-5, p.578 • Observation • orbital lacerations? • dec. ROM possible • periorbital edema & ecchymosis • Palpation/Examination • periorbital tenderness • neuro. Sensory eval.

  11. Hyphema--p.573 • Sign of internal damage to globe • Blood pooling in anterior chamber of eye • acute or delayed • Refer to physician immediately

  12. Corneal abrasion--p.577 • Table 16-3, p. 578 • acute onset--intense pain • no obvious abrasion although redness possible • possible photophobia • fluorescein strips for testing • blurred vision possible 2° injury or tears/watering

  13. Iritis--p.579 • Table 16-7, p. 580 • Acute traumatic onset • photophobia common • sluggish pupil • anisocoria possible

  14. Detached retina--p.579 • Trauma/jarring to the head • c/o “curtain” effect • visual field narrows • reports flashes, blind spots, or halos

  15. Conjunctivitis--p. 580 • Table 16-9, p. 581 • “pinkeye”;infection • acute onset • redness, lid edema • vision disturbances • HIGHLY contagious • Do NOT allow contact lenses • refer to physician

  16. Foreign Bodies--p.580 • Troublesome, but easily treated • proper treatment avoids abrasions, impalement, & infection • removal should not cause further injury • flush eye with saline • dry gauze • natural tearing • avoid dry cotton

  17. Special Testing • Snellen Test • Reflexes • Blink • Pupillary Reaction test--p. 575 • Direct light reflex • Consensual light reflex

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