eye injury/trauma
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Etiology
- mechanical injury to globe
- chemical injury
Clinical manifestations
- mechanical injury to globe
- cornea may be normal or damaged
- irregular or deviated pupil towards the direction ofthe injury
- hyphema
- red eye, conjunctival hemorrhage
- ocular pain
- vision may be normal or decreased
- chemical injury
- cornea may have minor epithelial damage or be opaque
- ocular pain
- blurred vision
- reflex blepharospasm
- photophobia
- foreign body sensation
- red eye, conjunctivitis
Radiology
- CT of orbit (image)[2]
Complications
Differential diagnosis
Management
- generally, depending upon severity, immediate referral to ophthalmology
- mechanical injury to globe
- leave imbedded foreign object in place
- avoid direct pressure on the orbit
- protect with eye shield
- tonometry is contraindicated
- chemical injury
- irrigate eye with normal saline or lactated Ringer's,
- 1-2 liters (minimum)
- continue eye wash enroute to emergency department
- continue until pH tested with litmus paper normalizes[3]
- 1-10 liters maybe necessary[3]
- sodium bicarbonate is never appropriate[3]
- immediate referral to ophthalmology
- irrigate eye with normal saline or lactated Ringer's,
- eye surgery may be necessary to remove eye foreign bodies
- prevention
- protective eyewear[2]
More general terms
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
- ↑ 2.0 2.1 2.2 Gupta PC, Ram J. Eye Injury from a Firecracker. N Engl J Med 2017; 376:2579. June 29, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28657877 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMicm1616104
- ↑ 3.0 3.1 3.2 3.3 NEJM Knowledge+ Ophthalmology
Pargament JM, Armenia J, Nerad JA. Physical and chemical injuries to eyes and eyelids. Clin Dermatol. 2015 Mar-Apr;33(2):234-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25704943 Review.