OPHTHALMOLOGY
GLOBE RUPTURE
Prompt
Response
Lacerated sclera (R)
Uveal prolapse
Misshapen pupil
Cloudy cornea (L)
(CT - Globe rupture, infeior orbital floor # with depression, inferiro rectus displacement, haemorrhage/air in maxillary sinus)
Negative findings - ?no hyphema, ?no extraoccular trauma
Lacerated sclera (R)
Uveal prolapse
Misshapen pupil
Cloudy cornea (L)
(CT - Globe rupture, infeior orbital floor # with depression, inferiro rectus displacement, haemorrhage/air in maxillary sinus)
Negative findings - ?no hyphema, ?no extraoccular trauma
PromptHistory in stems
ResponseWalked into something, eye injury while hammering metal,
PromptOcular globe rupture - Clinical presentation
ResponseVitreous humor leak
Dark uveal tissue exposed at limbus
Decreased VA
Subconjunctival haemorrhage with swelling/chemosis
Uveal Prolapse
Positive Seidel test - Aqueous flow on fluorescein staining (Image from google)
Dark uveal tissue exposed at limbus
Decreased VA
Subconjunctival haemorrhage with swelling/chemosis
Uveal Prolapse
Positive Seidel test - Aqueous flow on fluorescein staining (Image from google)
PromptInvestigations
ResponseCT/US - ? FB
Fail if says MRI (METAL IN EYE)
Fail if says MRI (METAL IN EYE)
PromptManagement
ResponseUrgent ophthalmology referral
Lie flat, avoid external pressure on eye
Eye shield (hovers above eye), not eye pad
ADT
IVABx - Broad spectrum - Cefzolin/gent, Tazocin (No common answer here - ?Ciprofloxacin 750 mg PO - ETG to prevent endopthalmitis)
Analgesia (Fentanyl), IV antiemetics
Sinus precautions
Lie flat, avoid external pressure on eye
Eye shield (hovers above eye), not eye pad
ADT
IVABx - Broad spectrum - Cefzolin/gent, Tazocin (No common answer here - ?Ciprofloxacin 750 mg PO - ETG to prevent endopthalmitis)
Analgesia (Fentanyl), IV antiemetics
Sinus precautions