The cornea is the clear outer layer of the eye that focuses light. Corneal injury or abrasion occurs when the cornea's surface is damaged. Common causes include chemical burns, contact lens overuse, dust, and scratches. Symptoms include eye pain and sensitivity to light. Treatment involves antibiotic eye drops to prevent infection along with pain medication. Patching the eye is not recommended as it does not improve healing and can increase pain. Close follow up is needed to monitor for complications like infection or ulcer.
The most common presenting complaint of Ophthalmology in Emergency dept. is Foreign body sensation, so just to recall the basics of Ophthalm in ED, read the following PPT.
The most common presenting complaint of Ophthalmology in Emergency dept. is Foreign body sensation, so just to recall the basics of Ophthalm in ED, read the following PPT.
BLEPHARITIS
Blepharitis is a chronic inflammation of the lid margins.
Etiology
1. It follows chronic conjunctivitis due to Staphyloccocus in
debilitated children usually who are living in poor hygienic
conditions.
2. Parasites such as Demodex folliculorum, Phthiriasis
palpebrarum, crab louse, head louse also cause blepharitis.
A stye is an infection (abcess) of one of the small oil producing glands lining the eyelid, usually caused by the bacteria that are normally found along the eyelids.
A stye can occur on either the upper or lower eyelid.
There are two types of styes, internal and external hordeola.
An internal hordeolum (stye) is a bacterial infection of the meibomian glands inside the eyelids.
Internal styes tend to be more severe and occur a little less often than an external hordeolum.
An external hordeolum (stye) is a bacterial infection of the Glands of Zeis and/or Glands of Moll inside the eyelids.
This type of stye is more superficial and tends to heal more readily.
It is a chronic lipogranulomatous inflammatory lesion caused by blockage of meibomian gland orifices and stagnation of sebaceous secretion.
Patient with acne rosacea or seborhoeic dermatitis are at increased risk of chalazion formation which may be multiple or recurrent.
If it is recurrent, one should think of sebaceous gland carcinoma
TONOMETRY • Tonometry is the procedure performed to determine the intraocular pressure (IOP).
3. CLASSIFICATION TONOMETRY DIRECT INDIRECT Indentation Applanation Manometer
4. APPLANATION Contact Non-contact Goldmann Perkins Air-puff Pulse air
5. INDENTATION TONOMETER • It is based on fundamental fact that plunger will indent a soft eye more than hard eye. • The indentation tonometer in current use is that of Schiotz . • It was devised in 1905 and continued to refine it through 1927.
6. PROCEDURE • Patient should be anaesthetising with 4% lignocaine or 0.5% proparacaine. • with the patient in supine position, looking up at a fixation target while examiners separates the lids and lower the tonometer plate to rest on the cornea so that plunger is free to move. •
This presentation describes the background of the cornea and the corneal diseases in general, also it describes in detailed manner how to manage the corneal ulcer with its different causes
Corneal injury describes an injury to the
cornea. The cornea is the crystal clear (transparent) tissue covering the front
of the eye. It works with the lens of the eye to focus images on the retina.
BLEPHARITIS
Blepharitis is a chronic inflammation of the lid margins.
Etiology
1. It follows chronic conjunctivitis due to Staphyloccocus in
debilitated children usually who are living in poor hygienic
conditions.
2. Parasites such as Demodex folliculorum, Phthiriasis
palpebrarum, crab louse, head louse also cause blepharitis.
A stye is an infection (abcess) of one of the small oil producing glands lining the eyelid, usually caused by the bacteria that are normally found along the eyelids.
A stye can occur on either the upper or lower eyelid.
There are two types of styes, internal and external hordeola.
An internal hordeolum (stye) is a bacterial infection of the meibomian glands inside the eyelids.
Internal styes tend to be more severe and occur a little less often than an external hordeolum.
An external hordeolum (stye) is a bacterial infection of the Glands of Zeis and/or Glands of Moll inside the eyelids.
This type of stye is more superficial and tends to heal more readily.
It is a chronic lipogranulomatous inflammatory lesion caused by blockage of meibomian gland orifices and stagnation of sebaceous secretion.
Patient with acne rosacea or seborhoeic dermatitis are at increased risk of chalazion formation which may be multiple or recurrent.
If it is recurrent, one should think of sebaceous gland carcinoma
TONOMETRY • Tonometry is the procedure performed to determine the intraocular pressure (IOP).
3. CLASSIFICATION TONOMETRY DIRECT INDIRECT Indentation Applanation Manometer
4. APPLANATION Contact Non-contact Goldmann Perkins Air-puff Pulse air
5. INDENTATION TONOMETER • It is based on fundamental fact that plunger will indent a soft eye more than hard eye. • The indentation tonometer in current use is that of Schiotz . • It was devised in 1905 and continued to refine it through 1927.
6. PROCEDURE • Patient should be anaesthetising with 4% lignocaine or 0.5% proparacaine. • with the patient in supine position, looking up at a fixation target while examiners separates the lids and lower the tonometer plate to rest on the cornea so that plunger is free to move. •
This presentation describes the background of the cornea and the corneal diseases in general, also it describes in detailed manner how to manage the corneal ulcer with its different causes
Corneal injury describes an injury to the
cornea. The cornea is the crystal clear (transparent) tissue covering the front
of the eye. It works with the lens of the eye to focus images on the retina.
18th International conference on OPHTHALMOLOGY AND VISION SCIENCE,April 24-25...OphthalmologyCongres
18th International Conference on
Ophthalmology and Vision Science
April 24-25, 2023 Amsterdam, Netherlands
Theme- Upgradation and modernization of ophthalmologists via new innovation and Research, which focuses on the most recent innovative improvements and research in the field of Ophthalmology
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. Anatomy
The cornea is a transparent cover over
the anterior part of the eye that
serves several purposes: protection,
refraction, and filtration of some
ultraviolet light. It has no blood
vessels and receives nutrients
through tears as well as from the
aqueous humor. It is innervated
primarily by the ophthalmic division
of the trigeminal nerve as well as the
oculomotor nerve.
3. Cont…
The
cornea is composed of the
following 5 layers (anterior to
posterior):
Corneal epithelium
Bowman layer
Corneal stroma
Descemet membrane
Corneal endothelium
4.
5. Corneal injury
Corneal injury describes an injury
to the cornea. The cornea is the
crystal clear (transparent) tissue
covering the front of the eye. It
works with the lens of the eye to
focus images on the retina.
6. Causes
Injuries to the outer surface of the cornea, called
corneal abrasions, may be caused by:
Chemical irritation from almost any fluid that gets into
the eye
Overuse of contact lenses or lenses that don't fit
correctly
Reaction or sensitivity to contact lens solutions and
cosmetics
Scratches or scrapes on the surface of the cornea
(called an abrasion)
Something getting into the eye (such as sand or dust)
Sunlight, sun lamps, snow or water reflections, or arcwelding
7. Cont..
Infections may also damage the cornea.
You are more likely to develop a corneal injury if
you:
Are exposed to sunlight or artificial ultraviolet
light for long periods of time
Have ill-fitting contact lenses or overuse your
contact lenses
Have very dry eyes
Work in a dusty environment
High-speed particles, such as chips from
hammering metal on metal, may become
embedded in the surface of the cornea. Rarely,
they may pass through the cornea and go deeper
into the eye.
8. Corneal abrasion
Corneal abrasion is probably the most
common eye injury and perhaps one
of the most neglected. It occurs
because of a disruption in the
integrity of the corneal epithelium or
because the corneal surface scraped
away or denuded as a result of
physical external forces. Corneal
epithelial abrasions can be small or
large
9. Cont…
Corneal abrasions usually heal rapidly, without
serious sequelae. But deep corneal involvement
may result in facet formation in the epithelium or
scar formation in the stroma.
Corneal abrasions occur in any situation that
causes epithelial compromise. Examples include
corneal or epithelial disease (eg, dry eye),
superficial corneal injury or ocular injuries (eg,
those due to foreign bodies).
12. Potential causes of corneal abrasion
include the following:
Injury (eg, fingers, fingernails, paper, mascara
brushes, tree branches, self-inflicted rubbing,
pepper-spray exposure, automotive frontal air
bags)
Blowing dust, sand, or debris
Extended contact lens wear
Ocular foreign bodies embedded under an eyelid
Iatrogenic - Unconscious patients, accidental
injury by health care workers, improper eyelid
patching in patients with Bell palsy, and other
neuropathies in which the eyelid cannot be closed
voluntarily
Corneal foreign bodies
13. Cont…
UV keratitis - History of exposure to
electric arc welding or tanning beds
without proper eye protection, history of
prolonged exposure to bright sunlight
without sunglasses (eg, snow blindness)
In persons with trachoma, the constant
corneal abrasion by lashes and inadequate
tears can produce corneal erosions,
ulceration, and scarring. These constitute
the major pathway to blindness in
trachoma.
14.
Contact lens trauma
Contact lens–induced epithelial defects or direct trauma
during lens insertion or removal can cause corneal
abrasions.
The most common trauma is an inferior abrasion of the
cornea caused by lens removal. Sometimes, the person's
fingernail slices the contact lens and also the cornea.
More often, the lens becomes slightly dehydrated at the
end of the day because of insufficient blinking. The lens
adheres to the cornea, removing the epithelium. This area
may not heal well, especially if the epithelial cells are
continually torn away. After the contact lens is removed,
the patient may feel discomfort; however, no pain occurs
when the lens is worn because it acts as a bandage.
Patients who incompletely blink and those who work in a
dry environment, read most of the day, or look at TV or
computer screens should be warned about this
complication.
15. Cont…
A foreign body may become trapped under a contact lens
and produce linear scratch marks on the cornea. The
total irregularity of these wavy abrasions is the clue to
this cause of injury.
overnight wearing of soft lenses, which do not provide
sufficient oxygen transmissibility to prevent hypoxia,
causes superficial desquamation of epithelium and
increases the propensity for abrasions.
Corneal swelling induced by overnight wearing of
contact lenses is the most important factor. The cornea
normally swells 2-4% during sleep. With a contact lens,
overnight swelling increases to an average of 15%, and
gross stromal edema can be present on awakening. In
some patients, induced corneal swelling can be
sufficient to cause bullae; these can rupture, leading to
epithelial defects.
16.
17. Sports-related injury
Corneal abrasions can occur in almost all
sports. They most frequently occur in
young people.
In places where soccer is played
frequently, impact with the soccer ball
causes approximately one third of all
sports-related eye injuries. Contrary to
previous ophthalmologic teaching that
balls larger than 4 inches in diameter
rarely cause eye injury, 8.6-inch soccer
balls cause most soccer-related eye
injuries, both serious
18. Cont…
Approximately
1 in 10 college
basketball players has an eye injury
each year. Most basketball-related
eye injuries are corneal abrasions
caused by an opponent's finger or
elbow striking the player's eye.
The incidence of severe eye injuries
in wrestling is low.
19. Eyelid surgery
In
patients undergoing eyelid
surgery, corneal abrasion can result
from sutures inadvertently placed
through the tarsus or conjunctival
surface. After sutures are placed, the
lid should be everted to check that
they are not exposed.
The globe and cornea should be
protected during dissection and
suture placement. A contact lens
corneal protector or lid plate can be
used.
20. Anesthesia
General anesthesia is more likely to cause adverse
systemic effects than local or ocular complications.
Ocular problems that do occur are usually not
serious and include corneal abrasion, chemical
keratitis, hemorrhagic retinopathy, and retinal
ischemia (rare).
The incidence of corneal abrasion from general
anesthesia is as high as 44%. Simple precautions,
such as instilling a bland ointment or taping the
lids of the nonoperative eye closed, may prevent
surface trauma produced by the surgical drape,
anesthetic mask, or exposure. Decreased tear
production under general anesthesia, proptosis,
and a poor Bell phenomenon may worsen corneal
exposure, requiring eyelid suturing in some
susceptible patients.
21. Tonometry
The plunger can cause corneal abrasion if the
eye or tonometer moves during measurement.
In addition, if the disinfectant solution (eg,
alcohol) is not removed from the plunger, it can
cause a local chemical keratitis where it
touches the cornea.
The Schiøtz tonometer must be used in the
supine position or in the sitting position with
the head back far enough to be horizontal. An
initial blink or avoidance reaction may occur as
the patient sees the tonometer descending
toward the eye.
22. Physical Examination
Visual acuity should be assessed. If the abrasion affects
the visual axis, there may be a deficit in acuity that
should be apparent when compared to the uninjured
eye.
If the examination is limited by pain, a topical
anesthetic such as tetracaine or proparacaine may be
used. The amount of anesthetic used should be
minimal, as these agents have been shown to slow
wound healing.
Visual inspection for foreign objects should be
performed. Both upper and lower eyelids should be
flipped in order to look for foreign bodies that may be
lodged in the upper eyelid, causing injury with eye
blinking.
The cornea can become hazy if there is edema due to
the abrasion. Conjunctival injection, usually located
23. Slit Lamp Examination
A topical anesthetic (ie, proparacaine,
tetracaine) may facilitate the slitlamp examination. Severe
photophobia that causes
blepharospasm may require
instillation of a cycloplegic agent (ie,
cyclopentolate [Cyclogyl],
homatropine) 20-30 minutes prior to
examination.
24. fluorescein instillation
Perform
fluorescein instillation and
examination with blue light. Fluorescein
can permanently stain soft contact
lenses. Do not forget to remove such
lenses before applying the stain.
Fluorescein is applied using a paper
strip applicator that is gently placed
over the inferior cul-de-sac of the eye
and allowing saline or anesthetic
solution to drop into the eye. Once the
patient blinks, the dye is spread over
the cornea.
25. Treatment
Corneal abrasions heal with time.
Prophylactic topical antibiotics are given
in patients with abrasions from contact
lenses. Traditionally, topical antibiotics
were used for prophylaxis even in noninfected corneal abrasions not related to
contact lenses, but this practice has been
called into question.
26. Cont…
Patching the eye has been used to help
relieve the pain associated with corneal
abrasion, but research has not shown
benefit from patching. Patching should
not be performed in patients at high
risk of infection, such as those who
wear contact lenses and those with
trauma caused by vegetable matter,
because of potential incubation of
infecting organisms and promoting
subsequent infectious keratitis.
27. Cont..
Some ophthalmologists advocate the use of
diclofenac (Voltaren) or ketorolac (Acular)
drops with a disposable soft contact lens in
addition to antibiotic drops. This therapy may
be an effective alternative to patching, as it
allows the patient to maintain binocular vision
during treatment and reduces inflammation.
Patients with all but the most minor abrasions
usually require a strong oral narcotic analgesic
initially. In addition, topical cycloplegics may be
required to relieve pain and photophobia in
patients with large abrasions until their healing
is nearly complete.
28. Cont.
Emergent ophthalmologic consultation
is warranted for suspected retained
intraocular foreign bodies. Urgent
consultation is needed for suspected
corneal ulcerations (microbial
keratitis).
29. Cont.
Fluoroquinolones (eg, ofloxacin) are probably the
most common agents used for prophylaxis with
corneal abrasions because of their broadspectrum coverage and low toxicity and
because of the low resistance of commonly
acquired organisms to these drugs. In addition,
fluoroquinolones have proven efficacy in the
treatment of bacterial corneal ulcers. Prolonged
and low-frequency dosing should be avoided to
discourage the emergence of resistant
organisms due to subinhibitory antibiotic
concentrations on the ocular surface.
30. Cont..
For large or dirty abrasions, many practitioners
prescribe broad-spectrum antibiotic drops, such
as trimethoprim/polymyxin B (Polytrim) or
sulfacetamide sodium (Sulamyd, Bleph-10),
which are inexpensive and least likely to cause
complications. Alternatives are an
aminoglycoside or a fluoroquinolone.
Abrasions due to contact lenses warrant
antibiotic treatment because of their propensity
to become infected corneal ulcers. Coverage for
gram-negative organisms
(especially Pseudomonas species) with agents
such as gentamicin (Garamycin), tobramycin
(Tobrex), norfloxacin (Chibroxin), or
ciprofloxacin (Ciloxan) is recommended.
31. Cont..
Antibiotic drops are more comfortable
than ointments but must be
administered every 2-3 hours.
Antibiotic ointments (eg, bacitracin,
polymyxin/bacitracin, erythromycin,
ciprofloxacin) retain their antibacterial
effect longer than drops and thus can
be used less often (every 4-6 h), but
they are more uncomfortable because
they can cause visual blurring.
Ointments are frequently used in
children whose crying washes out the
drops.
32. Cont..
Avoid antibiotics containing neomycin
(eg, Neosporin) because of the high
incidence of allergy to neomycin in
the general population. The use of
prophylactic periocular injections or
systemic administration of antibiotics
after corneal abrasions is
controversial.
33. Pain Management
The pain of corneal abrasions may be severe
and should be treated with nonsteroidal antiinflammatory drops and, if necessary, a soft
bandage contact lens. Narcotic analgesia is
occasionally required on a short-term basis.
These are continued until the pain decreases to
the point that it can be managed with over-thecounter analgesics.
34. Cont..
Instillation
of a long-acting cycloplegic
agent can provide significant relief for
patients with marked photophobia and
blepharospasm. These agents relax any
ciliary muscle spasm that may cause a
deep, aching pain and photophobia.
Cycloplegic agents are mydriatics;
therefore, to prevent an episode
of acute angle closure glaucoma, ensure
that the patient does not have narrowangle glaucoma.
35. Management of Small Corneal Abrasions
Small abrasions can be managed on an
outpatient basis. Ice compresses should be
used for 24-48 hours to reduce edema. Warm
compresses can be used thereafter.
Inform patients about the signs of wound
infection, including increasing pain, erythema,
edema, and purulent discharge. This helps in
making the decision for early antibiotic
intervention.
Patients must be informed about the signs and
symptoms of complications, such as foreign
body sensation, conjunctival injection, and
decreased vision, so that treatment can be
initiated promptly.
36. Patching
"Eye patching was not found to
improve healing rates or reduce pain
in patients with corneal abrasions.
Given the theoretical harm of loss of
binocular vision and possible
increased pain, the route of harmless
nonintervention in treating corneal
abrasions is recommended."
37. Follow-Up Care
Close follow-up care of corneal abrasions is
necessary because of the danger of the
abrasion progressing to an ulcer. Essentially all
corneal ulcers begin with an abrasion.
Abrasions resulting from vegetable matter are
at high risk for fungal ulcers. Abrasions
resulting from contact lens wear should be
monitored forPseudomonas infection and
amebic keratitis.
38. Cont..
Patients with abrasions should receive
follow-up care until healing is complete
and the fluorescein stain is negative, to
confirm that a corneal ulcer has not
developed. However, minor abrasions
should heal within 24-48 hours and do
not require follow-up if the patient is
completely asymptomatic at 48 hours.
Reexamine large abrasions frequently
until reepithelialization occurs and the
potential for infection no longer exists.
39. Cont..
Advise eye rest (i.e., no reading or work that
requires substantial eye movement that might
interfere with re epithelialization). Advise
patients to avoid bright light or to wear
sunglasses for comfort if they have notable
photophobia.
Patient with corneal abrasions that do not
resolve with the use of routine prophylactic
antibiotics must be evaluated for conditions
that impede healing; examples are infection,
neurotrophic keratopathy, and topical
anesthetic abuse.
40. Nursing Diagnosis for Corneal
Injury
1. Acute Pain related to trauma, increased
IOP, surgical intervention or
administration of inflammatory eye
drops dilator
Nursing interventions:
- Give the medication to control pain
- Give cold compress on demand for blunt
trauma
- Reduce lighting levels
- Encourage use of sunglasses in strong light
41. Cont..
Risk for self-care deficit related to damage
vision
Nursing interventions:
- Give instructions to the patient or the people
closest to the signs and symptoms,
complications should be immediately reported
to the doctor
- Provide verbal and written instructions to
patients and the right means of technique in
delivering drugs
- Evaluate the need for assistance after
discharge
- Teach patients and families of sight guidance
techniques
42. Cont..
Risk for Injury related to damage vision
Nursing interventions:
- Help the patient when able to do until a
stable postoperative ambulation
- Orient the patient in the room
- Discuss the need for the use of metal
shields or goggles when necessary
- Do not put pressure on the affected eye
trauma
- Use proper procedures when providing eye
drugs
43. Cont..
Anxiety related to damage to sensory and
lack of understanding of post-operative
care, drug delivery
Nursing interventions:
- Assess the degree and duration of visual
impairment
- Orient the patient to the new environment
- Describe the routine perioperative
- Encourage to perform daily living habits when
able
- Encourage the participation of the family or
the people who matter in patient care.
44. BIBLIOGRAPHY
Brunner, suddharth. Medical surgical
nursing. Virginia: a wulters kluwer
company; 2004: 964-968
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