1 An Intro to Ocular An Intro to Ocular Trauma/Flashes and Trauma/Flashes and Floaters Floaters Stephanie Stephanie Klemencic Klemencic, OD , OD Indiana University School of Optometry Indiana University School of Optometry Trauma History Trauma History Time, date and place Time, date and place Mechanism of trauma Mechanism of trauma Self treatment/First Aid Self treatment/First Aid Details of previous eye injuries and past Details of previous eye injuries and past ocular history ocular history Any change in condition or symptoms Any change in condition or symptoms since injury occurred since injury occurred General medical history General medical history Allergies Allergies Corneal Abrasion/Erosion Corneal Abrasion/Erosion Common culprits Common culprits Past ocular history/previous occurrence? Past ocular history/previous occurrence? Symptoms-pain, photophobia, tearing often on Symptoms-pain, photophobia, tearing often on waking waking Examination of patient Examination of patient – Always get a BVA Always get a BVA – Look for loose epithelium, small particles Look for loose epithelium, small particles – If indicated, evert the eye lids If indicated, evert the eye lids – Anticipate a subclinical anterior uveitis Anticipate a subclinical anterior uveitis – Sodium fluorescein Sodium fluorescein – Evert lids Evert lids – Measure the size of the lesion Measure the size of the lesion – Diagram the location of the lesion on the cornea Diagram the location of the lesion on the cornea
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Intro to Oc Trauma - IU Optometry · 1 An Intro to Ocular Trauma/Flashes and Floaters Stephanie Klemencic, OD Indiana University School of Optometry Trauma History Time, date and
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1
An Intro to OcularAn Intro to Ocular
Trauma/Flashes andTrauma/Flashes and
FloatersFloaters
Stephanie Stephanie KlemencicKlemencic, OD, OD
Indiana University School of OptometryIndiana University School of Optometry
Trauma HistoryTrauma History
Time, date and placeTime, date and place
Mechanism of traumaMechanism of trauma
Self treatment/First AidSelf treatment/First Aid
Details of previous eye injuries and pastDetails of previous eye injuries and pastocular historyocular history
Any change in condition or symptomsAny change in condition or symptomssince injury occurredsince injury occurred
General medical historyGeneral medical history
AllergiesAllergies
Corneal Abrasion/ErosionCorneal Abrasion/Erosion
Common culpritsCommon culprits
Past ocular history/previous occurrence?Past ocular history/previous occurrence?
Symptoms-pain, photophobia, tearing often onSymptoms-pain, photophobia, tearing often onwakingwaking
Examination of patientExamination of patient–– Always get a BVAAlways get a BVA–– Look for loose epithelium, small particlesLook for loose epithelium, small particles
–– If indicated, evert the eye lidsIf indicated, evert the eye lids
–– Anticipate a subclinical anterior uveitisAnticipate a subclinical anterior uveitis
Both acid and base solutions are capableBoth acid and base solutions are capableof causing significant destructionof causing significant destructionSeverity depends onSeverity depends on
-pH-pH
-Duration of contact-Duration of contact-Volume of solution-Volume of solution
-Solution-Solution’’s ability to penetrate corneas ability to penetrate cornea
Alkali caused a break down of the fatty Alkali caused a break down of the fattyacids in the cell membraneacids in the cell membrane
Chemical InjuryChemical Injury
Acids cause coagulation of proteins whichAcids cause coagulation of proteins whichfunctions as a barrier to furtherfunctions as a barrier to furtherpenetration. However, ocular surfacepenetration. However, ocular surfacecomplications can be very significantcomplications can be very significantThe degree of limbal ischemia relatesThe degree of limbal ischemia relatesclosely to the prognosis and the extent ofclosely to the prognosis and the extent ofsubsequent ocular surface problemssubsequent ocular surface problems
Loss of limbal stem cellsLoss of limbal stem cellsPoor epithelial healing is the major causePoor epithelial healing is the major causeof failure for corneal transplantation andof failure for corneal transplantation andattempts at visual rehabilitationattempts at visual rehabilitation
Chemical Injury TreatmentChemical Injury Treatment
Copious irrigation for 20-30 minutesCopious irrigation for 20-30 minutes
Test with litmus paperTest with litmus paper
Homatropine 5% in officeHomatropine 5% in office
Antibiotic gtts or ungAntibiotic gtts or ung–– VigamoxVigamox QID QID