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Ocular Trauma & Emergencies

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?.

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Ocular Trauma & Emergencies

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  1. Ocular Trauma &Emergencies Sam Alexander, MD

  2. Eye Trauma: Incidence • 1.3 million eye injuries per year in the United States • 40,000 of these injuries lead to visual loss

  3. The History: Vision • Are one or both eyes affected? • Vision at time of examination? • Vision prior to trauma?

  4. The History: Symptoms • Symptoms besides decreased vision? • Duration of symptoms? • Any surgery prior to trauma?

  5. The History: Vision • Are one or both eyes affected? • Vision at time of examination? • Vision prior to trauma?

  6. Complete Eye Examination • Vision • External exam • Pupils • Motility exam • Anterior segment • Ophthalmoscopy • Pressure • Visual fields

  7. Chemical Burns • A true ocular emergency • Alkali more serious than acid • Immediate irrigation essential

  8. Irrigation of chemical burns should be initiated before arrival at emergency center.

  9. Chemical Burns: Initial EC Management • Topical anesthesia • Copious irrigation • Check for foreign bodies

  10. Chemical Burns: EC Treatment Following Irrigation • Topical cycloplegic • Topical antibiotic • Patch eye • Prompt referral to ophthalmologist

  11. Management of Hyphema • Assume globe is ruptured • Shield eye and refer to ophthalmologist • 25% of patients have other ocular injuries

  12. Orbital Trauma: Isolated Blow-Out Fractures • Surgery indicated only for persistent diplopia or poor cosmesis • Surgery can be delayed since diplopia may be transient

  13. Superficial Lid Lacerations • Avoid lid margin retraction • Give tetanus prophylaxis • Remove superficial foreign bodies • Rule out deeper foreign bodies

  14. Corneal Abrasions: Symptoms • Foreign body sensation • Pain • Tearing • Photophobia

  15. Corneal Abrasions: Treatment • Topical cycloplegic • Topical antibiotic

  16. Questions? Thank You!

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