1. EYE TRAUMATHOLOGY EYE Pavel Stodůlka

2. HIGH RISK OF TRAUMA in today’s daily life Car accidents industry HIGH RISK OF TRAUMA in today’s daily life Car accidents industry

3. EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY combined 4. HEAT 5. CHEMICAL

4. EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY combined 4. HEAT 5. CHEMICAL

5. MECHANICAL 1. Structure - conj, cornea... 2. mechanism – foreign bodies - sharp x blunt - sharp x blunt 3. nonpenetrating x penetrating a) with foreign body a) with foreign body b) without foreign body b) without foreign body

6. CONJUNCTIVA & CORNEA 1. EROSION of cornea 2. RECURRENT EROSION 3. NONPENETRATING WOUNDS (ointment x suture) (ointment x suture) 4. PENETRATING WOUNDS (patching both eyes, suture) (patching both eyes, suture)

7. SCLERA 1. PENETRATION a) sclera only a) sclera only b) sclera & cornea b) sclera & cornea If corpus cilliaris also – severe bleeding If corpus cilliaris also – severe bleeding If extends more than 5mm behind limbus – retinal trauma If extends more than 5mm behind limbus – retinal trauma

8. FOREIGN BODIES

9. 1. anamnesis (wind x hammer on chisel) 2. When foreign body suspected: CT CT

10. FOREIGN BODIES of CONJUNCTIVA & SCLERA FOREIGN BODIES of CONJUNCTIVA & SCLERA u feels just like erosion

11. u Superficial - wipe out by cotton tipped stick - turn over eyelid - turn over eyelid u deeply driven – dig out by needle - clean rusty remnants - clean rusty remnants - ATB ointment - ATB ointment Treatment: FOREIGN BODIES of CONJUNCTIVA & SCLERA FOREIGN BODIES of CONJUNCTIVA & SCLERA

12. w ANAMNESIS - metalosis - siderosis (Fe) - chalkosis (Cu) - chalkosis (Cu) blockage of enzymes in retinal rods & cones blockage of enzymes in retinal rods & cones regular follow ups with ERG regular follow ups with ERG w CT MATERIAL of FOREIGN BODIES MATERIAL of FOREIGN BODIES

13. u METAL - magnetic x nonmagnetic Fe 75% Fe 75% u NON METAL - inert x organic ( Fu, Cu & organic has to be removed ) MATERIAL of FOREIGN BODIES MATERIAL of FOREIGN BODIES

14. THERAPY u SUTURE - ASAP u REMOVAL of foreign body - forceps - magnet - magnet u VITRECTOMIY u ATB

15. DOUBLE PENETRATION Foreign body gets in the eye Foreign body gets in the eye and leaves it somewhere back. RISKS: endophtalmitis retinal detachment retinal detachment

16. MECHANICAL TRAUMA

17. u SOLID ORBITAL RIM u SOLID EYE WALL

19. CAN HIT ALL EYE STRUCTURES CAN HIT ALL EYE STRUCTURES MECHANICAL TRAUMA

20. EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY combined 4. HEAT 5. CHEMICAL

21. BREAK ! BREAK ! Pavel Stodůlka, MD, PhD stodulka@lasik.cz www.LASIK.cz

22. EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY combined 4. HEAT 5. CHEMICAL

23. Radiation trauma IR UV radioactive lasers solar

24. u glassblower cataract - history I R = heat

25. u ophtalmia fotoelectrica - welding - germicids - germicids - high mountains - high mountains u destroys corneal epithelial cels u pain 6 to 10 hours after (often come at night) u fluorescein dot like staining of cornea UV

26. u lubricating ointment UV Therapy:

27. u industrial accidents u terrorism u tumor therapy RADIOACTIVE

28. u the same as UV exposure, but milder u lens at risk too (delayed cataract) Radioactive Signs:

29. u lubricating ointment Radiactive Therapy:

30. u laser pointers u reflected laser beam (gogles) LASERS

31. u SOLAR RETINOPATHY u UV exposure – corneal epithelial defects SOLAR

32. EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY combined 4. HEAT 5. CHEMICAL

33. u eye burns u cataract ELECTRICITY

34. EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY combined 4. HEAT 5. CHEMICAL

35. u hot liquids u steam u molten metals HEAT

36. u temperature u time u volume HEAT

37. EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY combined 4. HEAT 5. CHEMICAL

38. u ACIDS: coagulation & necrosis coagulation & necrosis u : ALKALINES colliquation & necrosis colliquation & necrosis CHEMICAL

39. most often and very dangerous: most often and very dangerous: unslaked LIME burn CHEMICAL BURN

40. water & water & water removal of chemical remnants chemical neutralization Chemical burn First aid:

41. prim. MUDr. Pavel Stodůlka, Ph.D. stodulka@lasik.cz www.LASIK.cz