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Download Traumatic Hyphema : Management
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SPOT DIAGNOSIS DARINDA ROSA R2 Ocular Emergencies 2 Q.1 3 Traumatic Hyphema 4 Traumatic Hyphema Disruption of blood vessels in the iris or ciliary body Blood in anterior chamber 5 Traumatic Hyphema : Classification Grade Size of Hyphema 0 No layered blood circulating red blood cells only I Less than 1/3 II 1/3 to 1/2 III 1/2 to less than total IV Total 6 Traumatic Hyphema : Management Elevate the patient’s head Bed rest 1% atropine one drop 3-4 times daily 1% prednisolone acetate one drop 3-4 times daily If the globe is intact, measure IOP Reduce IOP Ophthalmology consult 7 Traumatic Hyphema : Management Rebleeding can occur 3 to 5 days later in 30% Uncontrolled glaucoma or blood stained cornea requires anterior chamber “wash out” 8 Q.2 9 Chemical Ocular Injury : Classification Grade I Grade II Grade III Grade IV 10 Chemical Ocular Injury : Management Preservative-free artificial tears Topical non-preserved steroid Topical cycloplegic Topical antibiotics Oral analgesics Pressure patch or bandage CL Antiglaucoma + 11 Chemical Ocular Injury Bilateral Alkali Injuries 12 Chemical Ocular Injury : Management Keratoprosthesis Corneal Transplantation 13 Q.3 14 Subconjunctival Hemorrhage Causes • Trauma, Hypertension • Valsava pressure spikes • Spontaneous No treatment Resolve within 2 weeks 15 Q.4 16 Corneal Abrasion Pain , photophobia , FB sensation, tearing Conjunctival injection, swollen eyelid Epithelial staining defect with fluorescein 17 Corneal Abrasion : Management Searching for conjunctival foreign body Topical cycloplegia, ATB ointment Pressure patching for 24 hours Don’t apply PP if there is a significant risk of infection. 18 Q.5 Eye Shield 19 Corneal Ulcer Hypopyon No patching Topical antibiotics Ophthalmologist referral Eye Shield 20 Acute Eye Conditions Emergency Very Urgent Urgent ( Immediately ) ( Within a few hours ) ( Within one day ) Retinal arterial occlusion Chemical burns Perforation Orbital cellulitis Ruptured Orbital injury Acute glaucoma Corneal ulcer Sudden congestion Corneal abrasion proptosis Hyphema Intraocular FB Retinal detachment Macular edema 21 Ocular Emergencies Blunt trauma Trauma Penetrating trauma Non - trauma 22 Nontraumatic Ocular Emergencies Acute Dacryocystitis Ocular Emergencies Acute Dacryoadenitis Acute Hordeolum Preseptal cellulitis Spontaneous subconjunctival hemorrhage Ocular condiitons requiring immediate treatment Acute Angle-Closure Glaucoma Central Retinal Artery Occlusion Orbital Cellulitis Cavernous Sinus Thrombosis Endophthalmitis Retinal Detachment Toxic Causes of blindness Conjunctivitis Bacterial corneal ulcer Viral keratoconjunctivitis Acute hydrops of the cornea Hyphema Uveitis ( iritis & iridocyclitis ) Vitreous hemorrhage Retinal hemorrhage Central retinal vein occlusion Optic neuritis 23 Ocular burns and trauma Ocular Burn Alkali Burns Ocular Emergencies Acid Burns Thermal Burns Burns Due to Ultraviolet Radiation Mechanical Trauma to the Eye Penetrating or Perforating injuries Blunt Trauma to the Eye, Adnexa,& Orbit 1. Ecchymosis of the Eyelids 2. Lacerations of the Eyelids 3. Orbital hemorrhage 4. Fracture of the Ethmoid bone 5. Blowout Fractures of the Floor of the Orbit 6. Corneal Abrasions 7. Corneal & Conjunctival Foreign Bodies 24 Ocular Trauma Closed Globe Burn Laceration Open Globe Rupture Laceration Contusion Penetrating Perforating 25 26
