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Classification of ocular injuries

Classification of ocular injuries. Classification of ocular injuries. Mechanical injuries Blunt injuries Penetrating injuries Chemical injuries Physical injuries Flash burns Radiation injuries Scalds. Mechanical injuries (Blunt). Mechanical injuries (Penetrating). Chemical injuries.

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Classification of ocular injuries

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  1. Classification of ocular injuries

  2. Classification of ocular injuries • Mechanical injuries • Blunt injuries • Penetrating injuries • Chemical injuries • Physical injuries • Flash burns • Radiation injuries • Scalds

  3. Mechanical injuries(Blunt)

  4. Mechanical injuries(Penetrating)

  5. Chemical injuries

  6. Physical injuries

  7. Blunt injury Mechanism of injury

  8. Blunt injury Mechanism of injury

  9. Blunt injury Inside-out injury Mechanism of injury

  10. Penetrating injury Mechanism of injury

  11. Penetrating injury Outside-in injury Mechanism of injury

  12. Description of injury

  13. Description of injury

  14. Lamellar laceration Description of injury

  15. Laceration Description of injury

  16. Perforating injury Description of injury

  17. Intra-ocular foreign body Description of injury

  18. Closed globe injuries Eye injuries Contusion Lamellar laceration Open globe injuries Penetration Perforation IOFB Rupture ----------------------------Lacerations--------------------------

  19. Classification of ocular injuries • Injury to right eye!!!!! • Injury to left eye!!!!!!!!!! • Self injury after results!!!!!!!!!!!!!!!!!!! • Hit by girl-friend!!!!!!!!!!!!!!!!!!!! • Hit by wife!!!!!!!!!!!!!!!!!!!! • Injury by teacher!!!!!!!!!!!!!!

  20. Chemical injury to the eye Ocular emergency Dr Soujanya K

  21. Sources Dr Uma kulkarni

  22. Acids Common acids Common sources Battery acid (sulfuric) Glass polish (hydrofluoric) Vinegar (acetic) • Sulfuric acid • Sulfurous acid (most common) • Hydrofluoric acid (most serious) • Acetic acid • Chromic acid • Hydrochloric acid Dr Umakulkarni

  23. Alkalies Common sources Fertilizers Cleaning products (eg, ammonia) Drain cleaners (eg, lye) Oven cleaners Potash (eg, potassium hydroxide) Fireworks (eg, magnesium hydroxide) Cement (eg, lime) Common alkalies • Ammonia (most serious) • Lye • Potassium hydroxide • Magnesium hydroxide • Lime (most common) Dr Uma kulkarni

  24. Severity of chemical injury • Type • Volume • Concentration • Duration of exposure • Degree of penetration of the chemical Dr Uma kulkarni

  25. Acid injury Dr Uma kulkarni

  26. Acid injury H+ & Anion Dr Uma kulkarni

  27. Acid injury H+ & Anion Denaturation of proteins Precipitation of proteins Coagulation of proteins Dr Uma kulkarni

  28. Alkali injury Dr Uma kulkarni

  29. Alkali injury OH- & Cation Dr Uma kulkarni

  30. Alkali injury OH- & Cation Saponifies fatty acids Increases further penetration Increases IOP Inflammatory response Dr Uma kulkarni

  31. Symptoms • Pain (often extreme) • Foreign body sensation • Blurred vision • Excessive tearing • Photophobia • Red eye(s) Dr Uma kulkarni

  32. Conj. & corneal epithelium > Necrosis of the conjunctival and corneal epithelium > occlusion of the limbal vasculature

  33. Corneal stroma Deeper penetration - breakdown and precipitation of glycosaminoglycans and stromal corneal opacification Dr Uma kulkarni

  34. Anterior chamber penetration results in iris and lens damage

  35. Ciliary epithelial damage impairs secretion of ascorbate which is required for collagen production and corneal repair Hypotony and phthisis bulbi may ensue in severe cases

  36. Limbalischaemia; Dr Uma kulkarni

  37. grade 2 – corneal haze but visible iris details Dr Uma kulkarni

  38. (C) grade 3: corneal haze obscuring iris details; (D) grade 4:total corneal opacification

  39. Conjunctival bands symblepharon cicatricialentropion keratoprosthesis

  40. Treatment Treatment should be instituted IMMEDIATELY, even before talking history

  41. Emergency Treatment: Saline Copious irrigation (until neutral pH):, may range from a few liters to many liters (more than 8 to 10 L

  42. Tap water

  43. Lids should be retracted and fornices swabbed for particulate matter

  44. Management • Remove inciting chemical (irrigation) • Remove any particles • Control inflammation • Control pain • Control IOP • Prevent infection • Promote epithelial healing- Ascorbic acid • Prevent symblepheron Dr Uma kulkarni

  45. Prevention Dr Uma kulkarni

  46. Dr Uma kulkarni

  47. YENOPH -10 UNDERGRADUATE QUIZ

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