11. FOREIGN BODY-corneal/conjunctival
• Discomfort, watering, redness
• Pain and photophobia(corneal)
• Oblique illumination, slit lamp
• Removed with a needle under topical
anesthesia
• Sub tarsal objects can be swept away with a
cotton wool bud
• Radiography for any suspected intra ocular
foreign body.
12. TRAUMATIC HYPHEMA
• Disruption of blood vessels in the iris or ciliary body
• Mx
• Elevate head
• Bed rest
• 1% atropine 3-4 times daily
• 1% prednisolone 3-4 times daily
• If globe intact, measure IOP
• Reduce IOP
• Rebleeding may occur 3 to 5 days later
13. LID LACERATION
• MX
• Sharp or blunt trauma
• Remove foreign body- superficial or deep
• Give tetanus prophylaxis
• Look for assosciated damage
• Lid repair- three layers
14. PENETRATING/ RUPTURED GLOBE
• EXAMINATION
• Corneal or scleral laceration
• Severe chemosis and hemorrhage
• Intra ocular contents maybe outside the globe
• Limitation of extra ocular motility
• Shallow anterior chamber
• Irregular pupil
15. • Management
• Stop examination
• Shield the eye(do not patch)
• Give TT prophylaxis
• NPO and systemic prophylaxis
• Do not apply any topical preparations
• Radiological investigation
• Refer
16. Chemical ocular injury
• True ocular emergency
• Acid burns tend to coagulate proteins, limiting the depth of
penetration
• Alkali burns can rapidly penetrate the cornea, causing damage to intra
ocular structures
17. Management
• Immediate copious irrigation with a minimum of 1-2 litres of saline or until
pH is neutralized
• Topical anaesthetic
• Removal of necrotic tissue
• Double eversion of eyelids
• Artificial tears
• Topical steroids
• Topical cycloplegics and antibiotics
• Prevention of symblepharon, avoiding complications-glaucoma, opacity.
18. Cyanoacrylate glue
• Accidental entry into the eye can cause the lids to
adhere and adhesive clumps to form on the
cornea
• Not permanently harmful to the eye
• Management
• Moisten the glue with an ointment
• Remove as much possible without causing damage to
underlying tissue
• The glue will loosen and easier to remove in afew days
21. CENTRAL RETINAL ARTERY OCCLUSION
• C/O- Acute, painless loss of vision in the right eye
• Examination-
• visual acuity LP- in 90% of cases
• Opaque white retina and attenuated vessels
• Treatment-
• Ocular massage
• Inhaled O295% and CO2%
• Reduced intra ocular pressure
• Definitive- Ant. Chamber paracentesis
• - direct infusion of t-PA or urokinase in the
ophthalmic artery
22. ORBITAL CELLULITIS
• Eyelid edema and pain, worse on eye
movement
• Examination-
• Periorbital erythema and edema
• Proptosis
• Restricted extraocular motility
• Decreased visual acuity
• Chemosis
• Fever
• Management- broad spectrum iv
antibioics
• CT scan orbit
23. ENDOPHTHALMITIS
• Immediate treatment with
antibiotics
• Topical or parenteral
• Corticosteroids in patients with
poor eyesight
• Removal of infected tissue might
be required
24. RETINAL DETACHMENT
• Symptoms-flashes of light, floaters,darkening
of peripheral vision
• Fundoscopy
• Management- almost always surgical
• Laser/cryopexy
• Pneumatic retinopexy
• Scleral buckle
• Vitrectomy
