Ocular Trauma

Ocular trauma| eading cause of blindness among-duildren andyoung adults, especially male trauma victime.- can our due to:oucpational injuries (construction)contact sportsweapons (air guns I BB guns)assaultsMVA IS (broken windshields)explosions (blast fragments)First response IS chincal In1. chemical burn -eye should be immediatlyirrigated T/ap water or NS.2. Foreign body - & attempt should bemadeto remove the object.- prevent object from jarring or movement- Q pressure or patch should be appliedassessment dx findingsassess of the need for further tests include the natureof the ocular injury (blunt/ penetrating trauma)need to know whether onset of VISION loss wassudden ,Slow Iprogressivechenical bums need'to know what the agent is and test for PM.examine comeal surface for- foreign bodies-wounds- abrasionscheck pupil size, shaperlight reaction of the pupilob the affected eye are compared t/the other we.Check oular motilitymedical management tx:Splash injuriesirrigate C/NSdo Q further manipulate the eye until bt ISunder general anesthesia.parenteral broad spectrum ABX started.Tet shotanal gesic agentstopical op th almie medicationForeign Bodies and comeal abrasionsremove body foreign onlyABX ointment appliedeye patchedmonitor for infection until completely healedcontact lens - common cause of conneal abrasion1 : . patient WIII name severe pain wnlaantibiotic ointmentpressure patch to immobilize the eyelidstopical anesthetic eye drops must 0 be griento the patient to take home for repeated useafter comeal injury because their effects maskfurther damage delay healing and can leadto comeal scarringpenetrating injuries and contusions of the Eyeballcan rupture the eyeballI b rupture occurs rapid decompression or herniationof the orbital contents Into adjacent 81nuses canoccur.Blunt traumatic injuries have worse prognosisthan penetrating Injunes-penetrating injunes : result in marked loss of usionw/the following S/Shemowhage chemosisl edema of conjuctivaCO injuctival laverationshallow antenor chamber t for T/out eccentricallyplaced pupilmyphema (6700 01 T/In antenor chamber)Vitreous hemorhageIntraocular Foreign Bodieshaming upln r/A blumed VISAM AMA nvw VI"should be questioned carefully about recentinjunes /exposures.precipitating circumstances:-working in construction-striking metal against metal- being involved in MVA t/fairal injury-GSW-grinding wheel work-explosionsDX through : 8lit lamp biomicroscopyCTUltrasonography scanningMRI -contraindicated in DX intraocular foreign bodlesbecause most foreign bodus are metallic andmagnetic-Iron,Steel ,Copper, and vegetable matter may causeintense Inflammatory reactions-sx excision of the foreign body depends onits location and composition and associatedocular injuries.- special 10F forcess and magnets are used tograsp and remove the foreign body.Ocular BumsA 1kall, acid, and other chemically curneorganic substances, such as mall and tear gas, cause chemical burns.* Alkali burns - -result In the most severeinjury because they penetrate the ocular tissuesrapidly and continue to cause long term damage.10P also occussAuds = less damage blu the precipitated necticitissue proteins form a barrier to furtherpenetration and damage.chemical bums appear as superficial punctateKeratopathy subconfrectival hemorrhage, orcomplete marbleizing of the comea.tx: irrigate e/tap water on site be fore transferringto ED-- corneal surfaces and conjuctival bornies areimmediatry and copiously imgated T/NSor any mentral solution- local anesthetic applied t lid speculum.Fnermal injury: caused by exposure to a hotobject (caring iron, tobacco, ash.)tx: ABX agents and patch X 24hrs.