OCULAR TRAUMA - Michigan Optometric Association
OCULAR TRAUMA - Michigan Optometric Association
OCULAR TRAUMA - Michigan Optometric Association
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CT<br />
• If you suspect any of the previous, a CT scan is<br />
indicated<br />
• Axial and Coronal sections (1mm) needed for<br />
suspected blow out<br />
• No MRI for fear of metallic foreign body<br />
• Do not patch<br />
• Shield Eye<br />
• Send to ER<br />
11<br />
Open Globe<br />
• Disproportionate conjunctival edema could be<br />
a possible indication of scleral rupture<br />
Endophthalmitis – Strain Susceptibility<br />
Methicillin-Resistant S. aureus<br />
Gentamicin<br />
81%<br />
Trimethoprim<br />
74%<br />
Moxifloxacin<br />
45%<br />
Gatifloxacin<br />
32%<br />
Open Globe<br />
• Check VA - reduced<br />
• Seidel’s sign<br />
– Fl stain<br />
• Displaced pupil/expelled contents<br />
• Non-reactive pupil<br />
• Low IOP<br />
• Poor reflex<br />
• Hyphema<br />
10<br />
Endophthalmitis – Strain Susceptibility<br />
Coagulase Negative Staphlococci<br />
Gentamicin<br />
97%<br />
Trimethoprim<br />
66%<br />
Moxifloxacin<br />
53%<br />
Gatifloxacin<br />
50%<br />
Blunt Trauma<br />
• Check VA<br />
• Proptosis from retrobulabar hemorrhage<br />
• Contusion/sub-conj hemorrhage<br />
• Retinal detachment<br />
• Commotio Retinae<br />
• Traumatic uveitis or hyphema<br />
• Traumatic cataract<br />
• Blow out fracture<br />
2
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