1. Ocular trauma

2. Outline ocular trauma Ⅰ. mechanical factors Ⅱ. physical factors Ⅲ. chemical factors

3. Classification Causative factors of injury –Mechanical ocular trauma –Non-mechanical ocular trauma Degree of injury –Microtrauma –Moderate injury –Macrotrauma

4. Outline New classification Ocular trauma CloseOpen Contusion Laminar laceration Rupture Penetration Foreign body Penetration-through Laceration

5. Examination Examination of ocular trauma –History –General condition –Visual acuity –Extra-eye examination –eyeball examination –Assist examination

6. Treatment –to rescue life –chemical injury —— to rinse with mass of water –Open injury—— TAT –Penetration injury—— to avoid pressure –Reasonable antibiotics

7. Ocular contusion Ocular contusion ： caused by mechanical blunt force > 1/3 ocular trauma Causative factors of injury –Blunt body –High-pressure gas ／ fluid –Blunt force conduction —— indirect injury

8. Ocular contusion § Corneal Bruise § Iris and Ciliary Body Bruise Iris injury and pupil abnormity Iris injury and pupil abnormity Hyphema § Lens Bruise § Vitreous hemorrhage § Choroid Bruise § Retinal Commotion and Bruise

9. Corneal Bruise Clinical manifestation and treatment –Superficial lamella abrasion —— antibiotic ointment ＋ eyepatch and to avoid topical anaesthesia –Corneal stroma injury—— glucocorticoid ， mydriasis when necessary –Corneal rupture —— suture

10. Corneal Bruise

11. Iris and Ciliary Body Bruise TraumaTrauma iridocyclitis Clinical manifestationClinical manifestation ， –diminution of vision ， irritation –ciliary congestion –Iris edema, –Iris edema, blurred texture –Tyndall’s sign –KP TreatmentTreatment ／ –Glucocorticoid ／ NSAID –Mydriatic

12. Iris and Ciliary Body Bruise

13. Iris injury and pupil abnormity

14. Iris and Ciliary Body Bruise clinical manifestation Hyphema

15. Iris and Ciliary Body Bruise Hyphema Treatment –Semi-reclining position and resting –Double eyepatch –No Myosis nor Mydriasis –Cold pack first and then hot pack –Sedation –Hemostatic drug –Operation —— high IOP

16. Lens Bruise Change of lens transparence —— Traumatic cataract Treatment Operation

17. Lens Bruise Change of lens position Treatment –Operation

18. Vitreous hemorrhage

19. Treatment –A little —— Self-absorption –No absorption more than 3 months —— Vitrectomy –Retinal detachment —— Operation

20. Choroid Bruise Treatment No special treatment

21. Retinal Commotion and Bruise

22. Ocular rupture Clinical manifestation –IOP –Hyphema /vitreous hemorrhage –Subconjunctival hemorrhage or hematom –Corneal deformation –Limitation of eyeball movement –VA —— no LP Treatment –Exploration –treatment

23. Ocular Penetration

24. Complications –Traumatic iridocyclitis –Intraocular foreign body –Infectivity endophthalmitis –Sympathetic ophthalmia –Traumatic PVR

25. Ocular Penetration Basic principle –To Rehabilitate wound in time and recover ocular integrity –To prevent and treat infection and other complications Operation ： primary or secondary antibiotics ： local ／ general Atropine Glucocorticoid ／ NSAID ： local ／ general

26. Ocular Penetration

27. Foreign Body

28. Extraocular Foreign Body

29. Intraocular Foreign Body

30. Treatment principle –Diagnosis in time and operation at the right moment in order to keep and recover vision

31. Ocular Appendix Trauma

32. Eyelid Trauma

33. Orbital Trauma

34. Chemical Burn

35. Base burn –Tissue lysis ， easy pervasion and severe –Blurred circumscription ， progressive –corneal epithelium exfoliation ： usual –blood vessel invasion ： obvious –necrosis ： pervasion to deep –Intraocular damage ： yes Acid burn –coagulation necrosis ， reduce pervasion ， not severe relatively –Clear circumscription ， no progressive –corneal epithelium exfoliation ： occasional –blood vessel invasion ： no obvious –necrosis ： limit to contact surface –Intraocular damage ： little

36. Chemical Burn

37. First aid ： to rescue in time –To disengage chemical contact immediately and rinse in locale as soon as possible ： mass of water ， long time –Neutralization ： acid —— 2 ％ Sodium bicarbonate, sulfadiazine base —— Vitamin C Infection prevention ： antibiotic To promote healing ： epidermal growth factor ， Vitamin C prevention and cure symblepharon and other complication –mydriasis : Atropine –glucocorticoid –Collagenase inhibitor –Tear Substitute ／ contact lens Complication Treatment ： Operation

38. THANK YOU!