1. Ocular Trauma Sandra M. Brown, MD Associate Professor Ophthalmology and Visual Sciences

2. Nature of Injury Blunt Lacerating Chemical

3. Blunt Trauma Mild – moderate –“bruise” ocular tissues –Eye wall intact Moderate – severe –Rupture eye wall –Very severe consequences

4. Lacerating Trauma “cut” eye wall Outcome depends on extent and location

5. Location of Injury Anterior Segment Posterior Segment Adnexa Orbital Structures

6. Anterior Segment Conjunctiva Cornea Iris Lens

7. Posterior Segment Vitreous Retina Optic nerve

8. Adnexa Eyelids Lacrimal Structures

9. Orbital Structures Extraocular muscles Bony walls

10. Disgusting Photographs Front to back…

11. Racoon Eye

12. Lid Laceration

13. Subconjunctival Hemorrhage

15. Corneal Foreign Body

17. Corneal Abrasion

18. Curling Iron Burn

19. Corneal Laceration

21. Iris Sphincter Rupture

22. Hyphema

23. Traumatic Cataract

24. Vitreous Hemorrhage

25. Retinal Hemorrhage

26. Optic Disc Hemorrhage

27. Orbital Wall Fracture

28. Common Minor Eye Injuries Corneal abrasion Corneal foreign body Chemical splash Traumatic iritis

29. Diagnosis History –Sharp vs blunt vs chemical injury Exam –CHECK VISION

30. Diagnosis cont. Exam – Pry lids apart! –Cornea clear? –Pupil round? –Pupil black? –Blood clotted behind cornea?

31. Diagnosis cont. Exam –Red reflex? –Eyes move symmetrically?

32. Fluorescein Test Topical “eye dye” COBALT light

33. Corneal Abrasion

34. Abrasion Treatment Erythromycin ointment +/- patch 1-2 day follow-up with eye doc

35. Corneal Foreign Body

36. Foreign Body Treatment Anesthetize eye Remove FB –Cotton swab (don’t worsen abrasion!) –Kimura spatula –+/- needle tip E-mycin and +/- patch 1-2 day follow-up with eye doc

37. Chemical Splash

38. Chemical Treatment IRRIGATE Check pH Minor –E-mycin ointment –1 day follow-up eye doc Major –Same day eval by eye doc

39. Traumatic Iritis Moderate blunt injury Photophobia Lid bruising/edema Subconj heme or injection Pupil sluggish Eval by eye doc

40. Please Do Not Confuse Subconjunctival hemorrhage Hyphema