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-any injury that results in the compromise of the nasolacrimal system requires referral to subspecialists that are trained to repair these injuries -these may include: ophthalmic plastics, facial and reconstructive plastics, ear nose and throat |
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canthotomy and cantholysis |
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carotid cavernous fistula |
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Ocular Trauma info to collect |
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• History of injury/mechanism • Check vision/pupils |
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corneal abrasion • Acute / Painful / red / with or without loss of vision • History of trauma • Consider corneal foreign body depending on mechanism • Needs antibiotics to prevent infection • Ophthalmology consult for central defect or foreign body |
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chemical injury • Acid – coagulates tissue • Alkali – penetrates through tissue |
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corneal ulcer • Acute • Pain / redness / decreased vision / discharge • History of contact lens use or trauma • Urgent ophthalmology consult • Untreated or improperly treated can result in scarring with loss of vision, perforation, or endophthalmitis • Culture and frequent topical antibiotics |
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• Acute • Pain/redness/decreasedvision/discharge • Post-operative • Post-traumatic • Endogenous - Indwelling catheters - Intravenous Drug Use - Immunosuppressed (cancer patients) • Emergency ophthalmology consult |
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Acute Angle Closure Glaucoma • Acute • Painful / red / loss of vision • Nausea and vomiting • May have subacute presentation with intermittent headaches with haloes or decreased vision • History of being farsighted or angle closure in contralateral eye • Family history of angle closure glaucoma • Lower eye pressure • Break angle closure with medications or laser • Treat other eye |
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scleritis • Acute or subacute • Painful / red / with or without loss of vision • Beefy red eye • Deep, aching pain (often severe) - Sign of uncontrolled systemic inflammation - Untreated can lead to perforation of globe - Treat with NSAIDS or oral Steroids Associated with: • Rheumatoid arthritis or connective tissue disease (Lupus, HLA- B27) • Polyangiitis with granulomatosis • Polyarteritis nodosa • Sarcoidosis • Gout • TB • Syphilis • Lyme • Cat Scratch • HepBorHepC • May be idiopathic |
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