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4-9-08 Sue Renfrow

Eyes
Orbital Trauma
o Types
o Soft Tissue-surrounding tissues of the eye
o Orbital fractures-bone around eye seen on x-ray
o Foreign bodies
Ruptured globe
o Signs/Symptoms
o Irregular pupils (erupted will be larger)
o Deep anterior chamber
o Subconjunctival hemorrhage (see blood around it into the
subconjunctival)
o Low intraocular pressure
o Very poor vision
• Treatment

o Need IV

o Pain meds

o IV antibiotics

o Tetanus shot

Ruptured Globe/Foreign Bodies


• Usually tolerated unless copper or iron
• Prevention:
• Wear goggles when needed
• Wear protective clothing (especially if you are dealing with metal)
• Be aware of surroundings
• Treatment

o Florazine strips used to do eye exams-will see greenish look, then take
a woods lamp (black light) if there is an abrasion in the eye it will show
up with the black light

o Will irrigate if it is not metal

o DON’T FLUSH IF IT’S METAL BECAUSE IT WILL RUST

o Will get antibiotics, tetanus shot

o Ponticane drops into the eye

o Don’t let them drive home because their eyes will be dialated
o Antibiotic drops into the eye

Foreign Bodys
• Rust Ring-usually develop within 24 hours after having a piece of metal in
their eye
• Has to be surgically removed
o Can also have removed with magnet if it is not too deep

Ocular Trauma-leading cause of blindness in children due to motor vehicle accidents


o Trauma to the eye
o Chemical burns
o Put pH strip into eye

o Flush it out ASAP! Until pH strip is normal

o Lye and ammonia, no matter how much you wash it, it can still go
down into the eye

o Corneal abrasions-contact lenses are most common cause


o Penetrating injury-don’t take it out yourself-let surgeon remove it
o Retinal detachment
o Can happen in elderly people as a result of coughing

o First thing you notice is a change in their sight (seeing lights, and
curtains coming in from the side)

o Any kind of forward jerk or slamming back can cause this

o Conduct visual acuity test on people you think may have this (want
these people to be still and quiet)

Uveitis
oUveitis is the term used for inflammation of the uvea, the middle
layer of the eye between the outer white coating and the retina at
the back of the eye. It is in this area - bordering on many important
and vital parts of the eye - that many of the vital blood vessels are
located. As a result, a uveal inflammation could have more serious
consequences than inflammations of the outside layers of the eye.
• Need prompt treatment

Uveitis
Nongranulomatous-usually an acute condition
o Signs/Symptons
o Pain
o Photophobia
o Small/irregular pupil
o Blurred vision
o Hypopyon (pus)
4-9-08 Sue Renfrow

Granulomatous-tends to be chronic
o Signs/Symptoms
o Photophobia
o Minor pain
o Keratic (large grayish area)
o Vision affected
Treatment
o Eye drops to reduce inflammation and pain
o Mydriasis (dilates the eye)/Cycloplegia
 Side effect: dry mouth

 Cyclogyl/Atropine

• Paralysis to the eye

• Often used with mydriasis

o Effects last for about three hours

• Can cause CNS stimulant in children

• Can make BP goes up

o Pred Forte/Flarex-corticosteroids
o Wear dark glasses outdoors
• Treat asap to prevent loss of vision

Complications
o Glaucoma-increased pressure in the eye
o Cataracts-clouding of the lens of the eye
o Neovascularization-new blood vessels to get blood to the eye
Conjunctivitis (Pink eye)-most common eye disease worldwide because it is so
contagious
o Inflammation of the conjunctiva-may go away on its own
o Manifestations
o Sensation of foreign body
o Scratching or burning
o Itching
o Photophobia
Conjuctivitis Assessment
• Discharge (purulent, mucoid, watery, etc.)
• Type of reaction (what part of the eye is involved, is it
caused by allergies, toxic, etc)
• Presence of pseudomembranes
• Presence or absence of lymphadoneopathy
(enlargement of lymphnoid area around the neck)
• If eyes are crusted together get warm, wet, washcloth to open the eye up,
then put drops in
• To decrease pain, cool washcloths help

Types
• Microbial-Bacteria/Viral
• Allergic
• Chlamydial/fungal
• Chemical/toxic
Ocular Tumor/Melanoma
o A malignant tumor of the retina, retinoblastoma
• Usually hereditary, usually has to have entire eye removed

• Ocular Melanoma