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Ocular TraumaSandra M. Brown, MDAssociate ProfessorOphthalmology and Visual Sciences
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Nature of InjuryBluntLaceratingChemical
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Blunt TraumaMild moderatebruise ocular tissuesEye wall intactModerate severeRupture eye wallVery severe consequences
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Lacerating Traumacut eye wallOutcome depends on extent and location
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Location of InjuryAnterior SegmentPosterior SegmentAdnexaOrbital Structures
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Anterior SegmentConjunctivaCorneaIrisLens
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Posterior SegmentVitreousRetinaOptic nerve
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AdnexaEyelidsLacrimal Structures
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Orbital StructuresExtraocular musclesBony walls
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Disgusting PhotographsFront to back
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Racoon Eye
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Lid Laceration
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Subconjunctival Hemorrhage
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Corneal Foreign Body
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Corneal Abrasion
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Curling Iron Burn
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Corneal Laceration
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Iris Sphincter Rupture
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Hyphema
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Traumatic Cataract
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Vitreous Hemorrhage
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Retinal Hemorrhage
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Optic Disc Hemorrhage
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Orbital Wall Fracture
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Common Minor Eye InjuriesCorneal abrasionCorneal foreign bodyChemical splashTraumatic iritis
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DiagnosisHistorySharp vs blunt vs chemical injuryExamCHECK VISIONCHECK VISIONCHECK VISION
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Diagnosis cont.Exam Pry lids apart!Cornea clear?Pupil round?Pupil black?Blood clotted behind cornea?
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Diagnosis cont.ExamRed reflex?Eyes move symmetrically?
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Fluorescein TestTopical eye dyeCOBALT light
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Corneal Abrasion
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Abrasion TreatmentErythromycin ointment+/- patch1-2 day follow-up with eye doc
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Corneal Foreign Body
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Foreign Body TreatmentAnesthetize eyeRemove FBCotton swab (dont worsen abrasion!)Kimura spatula+/- needle tipE-mycin and +/- patch1-2 day follow-up with eye doc
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Chemical Splash
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Chemical TreatmentIRRIGATECheck pHMinorE-mycin ointment1 day follow-up eye docMajorSame day eval by eye doc
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Traumatic IritisModerate blunt injuryPhotophobiaLid bruising/edemaSubconj heme or injectionPupil sluggishEval by eye doc
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Please Do Not ConfuseSubconjunctival hemorrhageHyphema
