Uploaded byTONY SCARIA
Trauma to eye REVISION NOTES
This document discusses various types of eye trauma including open globe injuries, closed globe injuries, and injuries to specific structures within the eye. It provides details on blunt and penetrating trauma, complications like sympathetic ophthalmia, investigations like water's view, and foreign bodies involving metals like iron and copper. Trauma can cause injuries to the cornea, iris, lens, retina, and other structures and may lead to complications such as cataracts, glaucoma, or phthisis bulbi if not properly treated.
More Related Content
Similar to Trauma to eye REVISION NOTES
More from TONY SCARIA
Trauma to eye REVISION NOTES
- 1.
- 3. Open globe injuryClosed globe injury Injury with out full thickness defect of coats ocular injury without a full-thickness defect of the coats Contusion Lamellar laceration Rupture Laceration Injury d/t blunt trauma Partial thickness wound of coats d/t sharp object or blunt trauma Rupture of the sclera is an open- globe injury occurring from inside outwards. This is generally due to its being suddenly and violently forced against the orbital walls penetrating injury perforating injury Intraocular retained foreign body if the object traverses the coats only once if both an entry and exit wound are present,
- 5. Closed globe injuryby blunt trauma
- 6. Closed globe injuryby blunt trauma Cornea Sclera Iris & ciliary body Lens • Corneal abrasion • Corneal opacity • Blood staining of cornea • Rupture of globe • Intraocualr haemorrhage • post-traumatic iridocyclitis • traumatic miosis due to irritation of the nerves occurs initially in every severe contusion. • Traumatic mydriasis • Iridodialysis • D shaped pupil • traumatic aniridia or irideremia • Hyphaemia • angle recession glaucoma • Vossius ring on anterior capsule • Traumatic /rosette shaped concussion cataract • Subluxation / dislocation
- 7. Closed globe injuryby blunt trauma…. Retina Choroid Optic nerve Viteous • Berlins edema /commotio reinae • Traumatic macular degeneration:macular cyst or hole • Retinal tear & retinal detachment • traumatic proliferative chorioretinopathy secondary to haemorrhage into • the vitreous, leading to traction bands • Rupture • Choroidal haemorrhage • Choroidal detachment Optic atrophy • Intravitreal haemorrhage • appearance of clouds of fine pigmentary opacitiesmost common occurrence
- 8. Iridodialysis Iridodialysis, in whichthe iris is torn away from its ciliary attachment for a variable distance, occurs more frequently Iridodialysis A black biconvex area is seen at the periphery, and the pupillary edge bulges slightly inwards forming a 'D'-shaped pupil. 'D'-shaped pupil.
- 10. Vossius ring onanterior capsule ame diameter as the contracted pupil, and is due to the impression of the iris on the lens, produced by the force of the blow driving the cornea and iris backwards
- 11.
- 12. Commotio retinae (Berlinoedema) • milky white cloudiness • due to oedema appears over a considerable area at the • posterior pole which may sometimes disappear after a • few days when vision is usually restored
- 15.
- 16. • Bilateral, granulomatouspanuveitis • Develops following • Occurs after penetrating trauma, or less frequently following intra ocular surgery • 65% of cases occur between 2 weeks and 3 months after injury. • 90% of cases occur within first year
- 17. • Injury tociliary body sympathetic opthalmitis • Ciliary body is hence called as dangerous zone of eye
- 18. • Traumatized eyeis referred as the exciting eye • Fellow eye is sympathizing eye
- 19. • First symptom photophobia • First sign Retrolental flare • As inflammation starts in ciliary body
- 20. Symptoms • Prodromal symptomin sympathizing eye are: • Photophobia earliest symptom • Blurring of vision due to loss of accommodation
- 21. Signs Anterior segment Posteriorsegment • Red and irritable eye • Earliest sign – Retrolental flare as inflammation starts in ciliary body • Koeppe nodules • Mutton fat KPs • Posterior synechiae • Dalen Fuchs nodules – Small deep, yellow – white spots scattered through out the fundus. Dalen Fuchs nodules consist of epithelioid cells between retinal pigment epithelium and Bruch’s membrane • Optic nerve head – Oedema • Sub – retinal oedema
- 22. Dalen fuchs nodulein sympathetic opthalmitis granulomatous deposits b/w retinal pigment epithelium & Bruchs membrane
- 23. • Complications • 1.Complicated Cataract • 2. Secondary Glaucoma • 3. Phthisis bulbi
- 24. • Treatment : •Vigorous steroid therapy by all possible routes of administration. • Immuno suppressive therapy – with chlorambucil, cyclophosphamide or cyclosporin → in severe steroid resistant cases. • Enucleation–(NOT Evisceration) within 2 weeks of injury if above treatment fails.
- 26. Blow out #of orbit
- 27. INFERIOR WALL OFORBIT IS MOST COMMONLY INJURED IN TRAUMA
- 28. • Most commonlyinferior wall is fractured in its posteromedial part
- 29. BLOW OUT #OF FLOOR OF ORBIT • ENOPHTHALMOS • HERNIATION OF INFERIOR RECTUS MUSCLE RESTRICTION OF ELEVATION OF EYEBALL DIPLOPIA • INFRAORBITAL ANAESTEHSIA
- 31. Investigation • Waters view •Best view for floor of orbit waters view • Tear drop sign • Irregularity of floor of orbit
- 32. TEAR DROP SIGN TEARDROP SIGN
- 33. # roof oforbit
- 34. # roof oforbit • MC type of # of orbit encountered in early child hood • d/t blunt impact to the brow or forehead
- 35. Retention of foreignbodies
- 36. Foreign bodies ineye • foreign body most likely to penetrate & be retained in eye are minute chips of iron or chisel • Accounts for 90 % of fb in industry
- 37. Siderosis • Caused byiron foreign body Iris Lens Retina Secondary OAG Heterochromia iridis • Rusty deposits of iron in a ring shaped manner • Cataract • Pigmentary degeneratio n of retina
- 38. Chalcosis • Perforating injuryto eye with metal containing Cu • KF ring • Sunflower cataract • Golden plaque @ posterior pole of retina
- 39. Kayser Fleisher ringFleisher ring In chalcosis / Wilson disease In keratoconus d/t copper deposition in the Descemet's membrane in the sclero-corneal junction. d/t iron deposition at the base of cone of cornea