Download presentation
Presentation is loading. Please wait.
1
Visual prognosis among traumatic hyphemas
RED EYE and TRAUMA Visual prognosis among traumatic hyphemas Percent with final acuity No. of Patients Degree of hyphema >20/ <20/200 Hyphemas are serious! Note the percentage of patients who end up legally blind after 8 months. This is not due to blood in the anterior chamber but rather to collateral damage from the original trauma. Partial hyphema Total hyphema All hyphemas 191 36 227 77 33 70 16 55 22.5 8 month followup Am J Ophthal 5: 1, 1973
2
With muscle entrapment
RED EYE and TRAUMA OCULAR TRAUMA Orbital wall fractures Note the enophthalmos and exotropia. The secondary diplopia is the most incapacitating symptom. With muscle entrapment
3
Classic blowout fracture of orbital floor and ethmoids
RED EYE and TRAUMA Classic blowout fracture of orbital floor and ethmoids X-ray of the orbits of the previous patient. Note the opacification of the ethmoid sinus, the fluid level in the maxillary sinus, and the orbital tissue projecting through the floor into the antrum on the right side.
4
OCULAR TRAUMA Muscle entrapment Orbital floor fracture
RED EYE and TRAUMA OCULAR TRAUMA Muscle entrapment Orbital floor fracture This illustrates how the inferior rectus can become trapped. It must be surgically released to allow single vision.
5
RED EYE and TRAUMA OCULAR TRAUMA Entrapment of inferior rectus muscle following blowout fracture The inferior rectus on the left side is trapped, limiting vertical movement.
6
OCULAR TRAUMA Foreign bodies RED EYE and TRAUMA
Remember, not all ocular foreign bodies are found on the globe itself!
7
RED EYE (Rule out trauma) Foreign bodies Organic Metallic
RED EYE and TRAUMA RED EYE (Rule out trauma) Foreign bodies Organic Metallic Foreign bodies may be composed of any materials.
8
Corneal foreign bodies RED EYE and TRAUMA
Note the rust and surrounding corneal edema on the high power view that is not evident from simple naked inspection.
9
Now what? RED EYE and TRAUMA
Note the amount of rust remaining after the foreign body is removed. Iron is toxic to cells and prevents healing of the epithelial defect.
10
TO PATCH, OR NOT TO PATCH Cumulative incidence of corneal healing
RED EYE and TRAUMA Cumulative incidence of corneal healing Patched N=82 Non-patched N=81 Probability of corneal healing Patching does not speed epithelial healing and is generally applied only when a third or more of the epithelial surface has been removed. After 1 day After 2 days After 3 days 0.51 0.78 0.92 0.60 0.83 0.98 Le Sage, et al: Annals Emerg. Med. 38: , 2001
11
Wrong Right RED EYE and TRAUMA
Patching is only useful when applied as a semi-pressure patch that maintains closure.
12
Never patch more than 12 hours
RED EYE and TRAUMA Never patch more than 12 hours Remember, when you patch the eye closed, you are creating a perfect incubator for the native bacteria to thrive and multiply! Use antibiotic ointment
13
Semipressure patch RED EYE and TRAUMA
This semi-pressure patch is only applied correctly if the right eye remains closed upon opening the left one.
14
OCULAR TRAUMA Corneal abrasions RED EYE and TRAUMA
Note that fluorescein is useful in delineating the extent of the abrasion.
15
Fingernail damage RED EYE and TRAUMA
Corneal abrasions occur in many ways.
16
Curling iron Cigarette burn RED EYE and TRAUMA
Another reason not to smoke!
17
Airbag abrasions RED EYE and TRAUMA
A more modern technique to produce corneal abrasions. Airbag abrasions
18
OCULAR TRAUMA Chemical burns RED EYE and TRAUMA
Chemical burns are often devastating even though the initial presentation does not appear serious. The photo on the right was taken 3 months after the acute lye burn seen on the left photo.
19
BLUNT TRAUMA Retinal tears RED EYE and TRAUMA
Retinal holes occur in many forms, from atrophic thinning to horseshoe tears, and dialyses of the vitreous base.
20
RETINAL VISUALIZATION
RED EYE and TRAUMA RETINAL VISUALIZATION Limited views Traumatic retinal tears are usually located far anteriorly and out of the view of the direct ophthalmoscope.
21
BLUNT TRAUMA Retinal edema (commotio retinae) RED EYE and TRAUMA
While this looks rather awful, the edema may disappear completely and vision can return to normal. This picture is often seen in crushing chest injuries such as that caused by the steering wheel in a MVA.
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.