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Ocular Trauma Management Guide

1. Ocular trauma can occur from penetrating injuries such as sharp objects piercing the eye or blunt trauma from being hit with objects like balls. 2. Chemical injuries happen when hazardous materials like acids or alkalis come in contact with the eye and can cause deep burns and tissue damage. 3. For all types of ocular trauma, immediate irrigation of the eye is critical to wash out any foreign materials and bring the pH to normal levels. Patients also require prompt medical referral and examination to assess the extent of injury and determine appropriate treatment.

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Umar Azlan
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179 views19 pages

Ocular Trauma Management Guide

1. Ocular trauma can occur from penetrating injuries such as sharp objects piercing the eye or blunt trauma from being hit with objects like balls. 2. Chemical injuries happen when hazardous materials like acids or alkalis come in contact with the eye and can cause deep burns and tissue damage. 3. For all types of ocular trauma, immediate irrigation of the eye is critical to wash out any foreign materials and bring the pH to normal levels. Patients also require prompt medical referral and examination to assess the extent of injury and determine appropriate treatment.

Uploaded by

Umar Azlan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Ocular Trauma

Overview of the
presentation
1. Ocular trauma
1. -penetrating injury

2. Blunt Trauma

2. Chemical injury
Ocular trauma
• Penetrating • Blunt injury

• Perforating
Penetrating injury -
mechanism
• Direct trauma – sharp injury

Hammering a metal
MVA: windscreen injury
piece (no protection)
Penetrating injury
• Symptoms: • Signs:
o Pain o Conjunctival
injection / subconj.
o Reduced vision haemorrhage
o Photophobia o Corneal laceration
o Lacrimation / tearing o Pupil – abnormal
o Red eye shape
o Presence of foreign o Prolapsed of
body intraocular content
o Flat anterior
chamber
Penetrating injury – what
should we do ?
• Refer immediately
• Keep nil by mouth
(NBM)
• Shield the eye
• Never pad the eye
• No external pressure
on the eye
Penetrating injury -
management
• X-ray / CT Scan of
the orbit
• Anti tetanus
• Systemic antibiotic
• Emergency toilet &
suturing
• No eye drops –
ocular & retinal
toxicity
Skull X-ray: OMV/ Lateral
CT Scan Orbit
Blunt trauma
• Shuttlecock injury
• Tennis ball
• Bullet – toy gun
Blunt trauma -
mechanism
• Direct blow to the eye
• The eyeball will be
compressed antero-
posteriorly

• Sudden expansion of
the globe

• Contusional and
tearing damage
Blunt trauma
• Immediate ocular • Late ocular
injuries: complications:
 Hyphema ± 2*  Traumatic cataract
glaucoma  Secondary
 Vitreous glaucoma(angle
haemorrhage recession)
 Retinal detachment
 Traumatic optic
neuropathy
 Orbital wall fracture
causing diplopia
Chemical injury
• Alkaline injury:
o Deep penetration into the eye (e.g., cement /
plaster)

• Acid:
o Instantaneous coagulation necrosis and
precipitation of protein
o Limit the penetration

• Hydrofluoric acid (glass cleaning): rapidly


penetrates the eye
Chemical injury – what
should we do ?
• Immediate irrigation
• History taking while irrigating the eye
• Check the pH before and after
• Irrigation with normal saline at least for half an hour
(achieve pH 7.0)
• Remove loose material
• Evert the upper and lower eyelids
• Refer immediately
Chemical injury –
symptoms & signs
• Pain
• Reduced vision
• Foreign body sensation
• Photophobia
• Red eye
• Corneal abrasion/melt
• Eyes can be very
white  severe
ischaemia
Chemical injury – severe
complications
• Necrosis of the
conjunctiva
• Cornea stromal
opacification
• Iris and lens
damage
• Hypotony
Chemical injury -
treatment
• Lubrication
• Topical antibiotic(s)
• Topical corticosteroids
with strict precaution –
1 week
• Cycloplegic eye drop
• Surgical intervention –
amniotic membrane
transplant
• Corneal scarring –
corneal transplant
Thank you

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