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Comprehensive Overview of Blunt Ocular Trauma and its Effects on Vision

This document highlights the mechanisms and consequences of blunt ocular trauma, detailing how injuries to the anterior and posterior segments can lead to varied visual prognosis. It discusses complications such as hyphema, corneal opacity, traumatic mydriasis, and cataracts resulting from such trauma. The understanding of injury mechanics, including coup and contrecoup damages, helps in diagnosing and managing these conditions effectively. Key treatments for acute injuries and long-term care strategies emphasize the importance of monitoring changes over time to ensure optimal visual health outcomes.

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Comprehensive Overview of Blunt Ocular Trauma and its Effects on Vision

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  1. BLUNT OCULAR TRAUMA Dr Soujanya K

  2. general rule anterior segment, or the posterior half is preferentially affected.

  3. Delayed or progressive changes: in some cases • Guarded visual prognosis for all cases • Review for months to years

  4. Mechanics of concussion injuries

  5. Coup or Direct damage max. damage at the site of impact

  6. Contre-coup damage max. damage at a point distant from the actual site of impact

  7. Blunt injury Mechanism of injury Dr UmaKulkarni

  8. Blunt injury Mechanism of injury Dr UmaKulkarni

  9. Blunt injury Inside-out injury Mechanism of injury Dr UmaKulkarni

  10. A, direct impact; B, compression wave force; C, reflected compression wave; D, rebound compression wave.

  11. subconjunctivalhaemorrhage: no treatment.

  12. CORNEA Abration > distortion of corneal reflex > flouresceinstain > acute pain & lacrimation

  13. RECURRENT EROSIONS -Spontaneous or injury with babies’ fingernails. -Heals and recurs after days,weeks or months. - occurs on waking up in the morning - Epithelium loosely attached to the Bowmans membrane

  14. Treatment >Debridethe loose epithelium and > pad the eye for 48hrs or bandage soft contact lens.

  15. Anterior chamber

  16. Hyphema

  17. Blood Staining Of Cornea

  18. Blood Staining Of Cornea >colourdep [reddish brown or greenish ]-On duration >clears slowly from periphery

  19. CORNEAL OPACITY • Stromal edema • DM folds Stromal edema, DM Folds DM Tear

  20. Sclera • Partial thickness scleral wounds (lamellar scleral lacerations)

  21. Iris Traumatic miosis

  22. TRAUMATIC MYDRIASIS Large and immobile pupil minute ruptures in the pupillary margin

  23. Iridodialysis

  24. IRIDODIALYSIS • Black biconvex area at the periphery • D shaped pupil • Distant direct O’scopy- red glow in the periphery • Zonules may also be seen • Monocular Diplopia is a common complaint

  25. Traumatic Aniridia / Irideramia

  26. ANTEFLEXION OF THE IRIS Pigmented back of the iris faces forwards

  27. Retroflexion of the iris • Whole of the iris is doubled back into the ciliary region and becomes invisible.

  28. Aniridia Implants

  29. ANGLE RECESSION GLAUCOMA • Traumatic secondary open angle glaucoma • The ciliary body is torn- • longitudinal muscle remains attached to the spur at its insertion • circular muscle, pars plicata and the iris root are displaced posteriorly

  30. Clinical features • Unilaterally raised IOP • Abnormally deep AC in the involved meridian • Hyhaema • Gonioscopy- Irregularly broad CB bandassociated with changes of optic neuropathy.

  31. IRREGULAR BROADENING OF CB BAND

  32. Vosius Ring

  33. Circular ring of brown pigment –on ant. capsule. • Due to striking of the contracted pupillary margin against the crystalline lens. • It is always smaller than the size of the pupil.

  34. Concussion cataract • Imbibition of aqueous • Direct mechanical

  35. Early Rosette Cataract Feathery lines of opacities along the star-shaped suture lines; usually in the posterior cortex

  36. LATE ROSETTE CATARACT • Posterior cortex, 1 to 2 years after the injury. • Its sutural extensions are shorter and more compact

  37. TOTAL TRAUMATIC CATARACT

  38. Discrete subepithelial opacities • Traumatic zonular cataract. • Early maturation of senile cataract • Traumatic absorption of the lens

  39. TRAUMATIC SUBLUXATION & DISLOCATION OF LENS

  40. TRAUMATIC SUBLUXATION OF LENS

  41. LENS SUBLUXATION

  42. ANTERIOR DISLOCATION OF LENS

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