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Traumatic myopia
Transient myopia that can occur after blunt ocular
trauma
Traumatic myopia tends to resolve without
treatment
Periorbital ecchymosis "black eye,"
blood accumulation in the eyelids,more noticeable
in the lower lid , forms an organized hematoma or
firm purplish-black mass
Treatment
cold compress intermittently for the first 48 hours,
followed by hot packs for 3 to 5 days thereafter
Eyelid lacerations
Superficial lacerations : clean the wound, irrigate,
remove any foreign material, apply AB ointment
and sterile dressing
Deeper lacerations : sutures
Complicated lacerations : oculoplastics consult
Subconjunctival hemorrhages
do not require treatment, resolve in 1 to 2 weeks
Conjunctival abrasions
-Produce fluorescein staining, subconjunctival
hemorrhage
-AB eo TID for 4 to 7 days, pressure patching for
24 hours
-Suturing, heal without surgical repair
Corneal abrasions
Seidel test History of rubbing or scraping the cornea
Treatment
Small to moderately: fairly tight-fitting bandage
lens + AB Large abrasions
: pressure patch +
AB
Cycloplegics and analgesic
Corneal laceration
Cutting or tearing the cornea
Seidel test can be crucial
Partial-thickness : treat like a corneal abrasion
Moderate to deep :
suturing
Chemical burns
Affect multiple ocular structures,potentially cause
blindness
Alkaline : hydrophilic and lipophilic
rapidly penetrate cell membranes
saponification,cell death
disruption of the extracellular matrix
Hyphema
Complication
3.5 to 38% of patients rebleed, 2 to 5 days after
about 30% have temporarily elevated IOP for 5 to
7 days
5% require surgical intervention
about 75% demonstrate some degree of angle
recession or iridodialysis
only 5% will develop secondary glaucoma.
Hemosiderosis
cornea becomes stained by blood
prolonged hyphema
elevated IOP
endothelial damage
Iridodialysis
Detachment of the iris root from the ciliary body
Produce corectopia (irregular pupil shape),
pseudo polycoria, and diplopia
Monitor for glaucoma
Treatment :opaque soft contact lens with a clear
pupil
Traumatic cataract
Lens subluxation
Globe Rupture
Globe rupture
The signs
Severe subconjunctival hemorrhage
Deep or shallow anterior chamber, hyphema,
irregularly shaped pupil , exposed uveal tissue
(appears brownish-red), an EOM restriction
,hypotony
Management
Suture, Eviseration
Globe Rupture
Retrobulbar hemorrhage
Orbital vessel ruptures and leaks blood products
into the orbit
The sign
non-pulsating exophthalmos
resistance to retropulsion, elevated IOP
EOM restriction, central retinal artery pulsation ,
choroidal folds, and possibly optic neuropathy
Treatment
Decrease IOP
Immediate surgical lateral canthotomy and
cantholysis to reduce orbital pressure
Orbital decompression
Arteriovenous fistulas
High-flow fistulas : traumatic basal skull fracture
The Signs
audible orbital bruit, pulsatile proptosis,
chemosis, orbital swelling, elevated IOP,
ophthalmoplegia, and retinal vessel congestion
Low-flow fistula
Insidious onset , not usually caused by trauma
associated with hypertension , arteriosclerosis
The signs
Mild orbital congestion , proptosis, low or no
orbital bruit, and normal to elevated IOP.
Orbital fractures
Common cause :
Blunt trauma
The signs
Crepitus or subcutaneous emphysema
Muscle entrapment and/or a nerve palsy ,
decrease facial sensitivity
Pre-retinal hemorrhage
Choroidal rupture
Purtscher's retinopathy
Traumatic Retinal
detachment