Eye trauma
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Questions and Answers

subconjunctival hemorrhage without a posterior limit can be a sign of .

lid haematoma {(Black eyes) (Panda eyes)}: usually innocuous.

True

Panda eye is seen in ---

Superficial lacerations are parallel to the lid margin without ______.

<p>gaping</p> Signup and view all the answers

Lid margin lacerations invariably ______ and must therefore be carefully sutured with perfect alignment to prevent notching.

<p>gape</p> Signup and view all the answers

Improper suturing may end with notching or ______ (scars) that causes foreign body sensation and then corneal abrasion.

<p>fibrosis</p> Signup and view all the answers

Canalicular laceration: should be repaired and aligned within 24 hrs and sometimes silicone tube is inserted to intubate the tear at the drainage system to achieve good ______.

<p>patency</p> Signup and view all the answers

Canalicular laceration: should be repaired and aligned within ______ hrs and sometimes silicone tube is inserted to intubate the tear at the drainage system to achieve good patency.

<p>24</p> Signup and view all the answers

Canalicular laceration: should be repaired and aligned within 24 hrs and sometimes silicone tube is inserted to ______ the tear at the drainage system to achieve good patency.

<p>intubate</p> Signup and view all the answers

An impure blow out fracture involves the ______ and adjacent facial bones in addition to one or more of the orbital walls.

<p>rim</p> Signup and view all the answers

Orbital floor blow out fracture is typically caused by a sudden increase in orbital pressure by a striking object greater than ______ in diameter.

<p>5cm</p> Signup and view all the answers

The fracture most frequently involves the floor of the orbit and occasionally the ______ wall may also be fractured.

<p>medial</p> Signup and view all the answers

Periocular signs: ______, edema and subcutaneous emphysema

<p>echymosis</p> Signup and view all the answers

_______ nerve anesthesia involving the lower lid, cheek, side of the nose, upper lip, upper teeth and gum.

<p>Infraorbital</p> Signup and view all the answers

Diplopia is described as double Diplopia when looking ______ or down gaze.

<p>up</p> Signup and view all the answers

Intraocular signs e.g. ______, angle recession, retinal dialysis.

<p>hyphema</p> Signup and view all the answers

Diplopia can be caused by which two factors in relation to the orbit?

<ol> <li>hemorrhage and edema of the orbit that transiently restrict extraocular muscle movement. 2. mechanical entrapment within the fracture line of the IR or IO muscle or adjacent connective tissues.</li> </ol> Signup and view all the answers

What is the typical cause of an orbital floor blow out fracture?

<p>A sudden increase in orbital pressure by a striking object greater than a certain diameter.</p> Signup and view all the answers

What are the periocular signs of a blow out fracture?

<p>Ecchymosis, edema and subcutaneous emphysema.</p> Signup and view all the answers

Enophthalmos: which is first delayed because of edema and later may even continue to increase up to 6 months after trauma because of ______.

<p>fibrosis</p> Signup and view all the answers

Superficial lacerations are parallel to the lid margin without ______.

<p>gaping</p> Signup and view all the answers

An impure blow out fracture involves the ______ and adjacent facial bones in addition to one or more of the orbital walls.

<p>rim</p> Signup and view all the answers

Investigations: 1. Plain radiograph or coronal CT scan which shows the site of the ______ and the herniated tissue.

<p>fracture</p> Signup and view all the answers

Hess chart to test the ocular motility and detect the under acting ______ muscle.

<p>extraocular</p> Signup and view all the answers

Sometimes other tests are needed to define ocular lesions, if any, e.g. ______

<p>Ultra sound</p> Signup and view all the answers

Factors determining complications of ______ fractures are: 1. fracture size. 2. herniation of ______ contents. 3. muscle entrapment.

<p>orbital</p> Signup and view all the answers

Medial orbital wall may less commonly get a blow out fracture when the ______ bone is involved and the medial orbital compartments might get entrapped or affected.

<p>ethmoid</p> Signup and view all the answers

Fractures that are _______ needs no surgical intervention

<p>small cracks without tissue herniation or muscle entrapment</p> Signup and view all the answers

Fractures >half of the floor with muscle entrapment , persistent vertical diplopia and / or enophthalmos >2mm should be surgically repaired within _______

<p>2 weeks</p> Signup and view all the answers

Fibrosis make the surgery difficult or impossible after _______ weeks

<p>2</p> Signup and view all the answers

______ trauma Causes: squash balls, luggage straps and champagne corks.

<p>Blunt</p> Signup and view all the answers

Hyphema: hemorrhage in the anterior chamber usually occurs in ______ and young persons.

<p>children</p> Signup and view all the answers

Hyphaema may cause secondary glaucoma by three ways: either through occluding of the trabecular meshwork by blood cells and proteins, or by pupillary block OR by the associated iritis and its complications e.g. Anterior and posterior ______.

<p>synechia</p> Signup and view all the answers

Corneal staining (haemosiderosis) can occurs duo to persistent ______ specially if associated with rising intraocular pressure (IOP).

<p>Hyphaema</p> Signup and view all the answers

It is due to deposition of iron on corneal endothelium which leads to sever affection of visual acuity (VA) where ______ indicated.

<p>penetrating keratoplasty</p> Signup and view all the answers

Corneal staining (haemosiderosis) can occurs duo to persistent Hyphaema specially if associated with rising intraocular pressure (IOP). It is due to deposition of iron on corneal endothelium which leads to sever affection of visual acuity (VA) where ______ indicated.

<p>penetrating keratoplasty</p> Signup and view all the answers

Hyphaema fills more than half of the anterior chamber, the patient should be admitted to hospital with complete ______ rest

<p>bed</p> Signup and view all the answers

Surgery ('Paracentesis') is indicated when there is persistent total hyphema, sever and persistant rising ______

<p>IOP</p> Signup and view all the answers

Washing of AC is usually done with replacement of blood by a visco-elasitc substance or ______ e.g. normal saline, ringer solution or balance salts solution (BSS).

<p>fluid</p> Signup and view all the answers

Traumatic ______ and hypotony

<p>uveitis</p> Signup and view all the answers

Cataract. Subluxation of the lens due to ______ rupture

<p>zonular</p> Signup and view all the answers

Rupture globe usually in the vicinity of ______ canal

<p>Schlemn</p> Signup and view all the answers

Which of the following is a posterior segment complication of blunt trauma?

<p>Optic neuropathy</p> Signup and view all the answers

What is the term for the concussion of the sensory retina leading to ischemic cloudy swelling of the retina?

<p>Commotio retinae</p> Signup and view all the answers

Which of the following can occur as a result of blunt trauma and may end in a macular hole?

<p>Concussion of sensory retina</p> Signup and view all the answers

______ is a posterior segment complication of blunt trauma.

<p>Posterior vitreous detachment (PVD)</p> Signup and view all the answers

______ of the retina can lead to macular hole after blunt trauma.

<p>Concussion of sensory retina</p> Signup and view all the answers

Optic neuropathy can occur due to ______ or avulsion after blunt trauma.

<p>optic nerve contusion</p> Signup and view all the answers

Plain radiographs are helpful in detecting ----- and -----.

<p>FB, fracture</p> Signup and view all the answers

------ is contraindicated when suspecting intraocular foreign body.

<p>MRI</p> Signup and view all the answers

Ultrasound can detect -----, ------, ---------, and --------.

<p>FB, rupture, suprachoroidal hemorrhage, RD</p> Signup and view all the answers

What is the primary reason for performing primary enucleation in cases of severely lacerated eye?

<p>To reduce the risk of sympathetic ophthalmitis</p> Signup and view all the answers

What is the most common cause of sympathetic ophthalmitis following penetrating ocular trauma?

<p>Uveal prolapse</p> Signup and view all the answers

______ and organic foreign bodies are prone to result in infections

<p>Stones</p> Signup and view all the answers

Iron and copper foreign bodies undergo dissociation and result in ______ and chalcosis respectively

<p>siderosis</p> Signup and view all the answers

The ocular reaction to an intraocular foreign body with a high copper content involves a violent endophthalmitis-like picture which often progress to ______ bulbi

<p>phthisis</p> Signup and view all the answers

Which type of intraocular foreign body is prone to result in infections?

<p>Stones</p> Signup and view all the answers

What is the toxic effect of an intraocular ferrous foreign body?

<p>Deposition of iron in the intraocular epithelial cells</p> Signup and view all the answers

What is the ocular reaction to an intraocular foreign body with a high copper content?

<p>Chalcosis</p> Signup and view all the answers

Chemical burns are caused by exposure to ______

<p>alkalis and acids</p> Signup and view all the answers

The severity of chemical burns depends on ______ factors

<p>chemical properties, area affected, duration of exposure, and related associated effects e.g. thermal effect.</p> Signup and view all the answers

Alkali burns typically penetrate ______ compared to acid burns

<p>deeper</p> Signup and view all the answers

Topical and systemic ascorbic acid(vitamin C ) to promote ______ synthesis.

<p>collagen</p> Signup and view all the answers

Topical citric acid to reduce ______ activity.

<p>neutrophil</p> Signup and view all the answers

Topical and systemic tetracycline to reduce ______ activity and to act as ______ inhibitor.

Signup and view all the answers

Topical and systemic ascorbic acid(vitamin C ) to promote ______ synthesis.

<p>collagen</p> Signup and view all the answers

Topical citric acid to reduce ______ activity.

<p>neutrophil</p> Signup and view all the answers

Topical and systemic tetracycline to reduce ______ activity and to act as collagenase inhibitor.

<p>neutrophil</p> Signup and view all the answers

Which treatment option is used to promote collagen synthesis?

<p>Topical and systemic ascorbic acid</p> Signup and view all the answers

What is the purpose of using topical citric acid in treatment?

<p>To reduce neutrophil activity</p> Signup and view all the answers

Which surgical treatment option is used to correct corneal opacity?

<p>C &amp; D</p> Signup and view all the answers

Which type of burns are more dangerous, alkali or acid?

<p>Alkali burns</p> Signup and view all the answers

What is the pathophysiology behind deeper penetration of alkali burns compared to acid burns?

<p>Acid coagulates surface proteins</p> Signup and view all the answers

What is the grading system for severity of chemical burns?

<p>Grade 1, Grade 2, Grade 3, Grade 4</p> Signup and view all the answers

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