Download Free Medical Ocular Trauma PowerPoint Presentation

Ocular Trauma PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical PowerPoint presentation titled "Ocular Trauma” by Sarah Welch.

This medical PowerPoint presentation is about ocular trauma, an injury to the eye or the surrounding area. This can include injuries to the eyelids, cornea, iris, lens, retina, optic nerve, or the bones surrounding the eye. Ocular trauma can be caused by a variety of factors, including accidents, sports injuries, assault, and falls.

Symptoms of ocular trauma can include pain, redness, swelling, blurred vision, double vision, light sensitivity, and loss of vision. In some cases, there may be an obvious foreign object in the eye or a visible injury to the eye.

If you suspect that you or someone else has suffered ocular trauma, it is important to seek immediate medical attention. Depending on the severity of the injury, treatment may include medication, surgery, or other medical interventions.

Prevention is key in avoiding ocular trauma. This can include wearing protective eyewear when participating in sports or engaging in activities that pose a risk of eye injury, such as using power tools or working with chemicals. Additionally, taking steps to prevent falls and other accidents can help to reduce the risk of ocular trauma.

Tags : ocular trauma, injury to the eye, Ophthalmology, Ophthalmology PowerPoint presentation

Published on : Jun 20, 2023 | Views : 3198 | Downloads : 8

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Ocular Trauma Sarah Welch Vitreoretinal Surgeon Eye Dept GLCC; Auckland Eye
Slide 2-

Outline Assessment of Trauma Types of injury Peri-ocular Anterior segment Posterior segment Chemical injury
Slide 3-

Epidemiology 40% of monocular blindness is related to trauma The leading cause of monocular blindness 70-80% injured are male Age range is 0-100 yrs but most are young average age 30yr Incidence of penetrating eye injuries: 3.6/100000 Incidence of Eye injuries requiring hospitalisation: 15.2 /100000
Slide 4-

Sources of Injury Blunt objects - 30-40% rocks, fists, branches, champagne corks Motor Vehicle Injuries - 9% Play or sports - 1/3 golf/squash balls, shoulder/elbow, bats/racquets, horse Falls - 4% Sharp objects - 18% Globe involvement in 22% of cases
Slide 5-

ppt slide no 5 content not found
Slide 6-

Assessment Rule out life threatening injuries Rule out globe threatening injuries Examine both eyes Image Plan for treatment
Slide 7-

History Mechanism of trauma blunt/penetrating/mixed forces involved Previous injuries Past ocular history Past medical history
Slide 8-

Examination Pt review are there life threatening injuries which need to be treated first? ?brain injury Facial Exam lacerations/bruising, numbness, weakness Ocular exam VA, lids and lacrimal system, orbital rim/orbital bones, ocular motility, globe, optic nerve
Slide 9-

ppt slide no 9 content not found
Slide 10-

Lids and orbits
Slide 11-

Assessment History Detailed as possible Time and nature of injury Missile, blunt, ? FB remaining, chemical etc Past ocular history Previous VA and lid function remember trauma is a recurrent pathology Med Hx ?tetanus, ? Anticoagulation
Slide 12-

Examination Rule out life threatening injuries Rule out globe threatening injuries Examine both eyes Assess lid trauma - document +/- photos Plan for repair
Slide 13-

Examination - lids Tissue loss Layers of lid Lid Margin Canaliculi Prolapsed fat/septal involvement Levator function Lagophthalmos Canthal tendon/angle
Slide 14-

Image CT - fine cuts orbits If ? FB If unable to determine posterior aspect of wound If suspect orbital fracture/ other injuries
Slide 15-

Repair Timing Ideally within 12-24 hours of injury Can delay up to 1 week Patient factors Gross swelling Ice packs to reduce ? steroid Anaesthesia GA / LA
Slide 16-

Repair: General Principles Clean wound Remove FB Minimal debridement Careful handling of tissues Careful alignment of anatomy Lid margins, lash line, skin folds etc Close in layers
Slide 17-

Simple laceration Minor, partial thickness May be steri-stripped if not under tension Sutures 6.0/7.0 absorbable (gut or vicryl) or non absorbable Remove at 5 days if non absorbable Deep lacerations Repair in layers as needed Identify septum and do not attach to muscle,skin or tarsus - risk of lid lag
Slide 18-

ppt slide no 18 content not found
Slide 19-

Lid Margin lacerations Approximate lid margin Tarsal plate first 6.0 vicryl suture - can use as traction 3-4 sutures to plate Spatulated needle is useful Align lashes - silk Skin - nylon or gut or vicryl
Slide 20-

ppt slide no 20 content not found
Slide 21-

Traumatic ptosis Trauma to levator aponeurosis and Mullers muscle To repair need to identify levator aponeurosis and reattach to tarsal plate GA (diffiult under LA) Beware involving septum Consider delayed repair (3/12)
Slide 22-

ppt slide no 22 content not found
Slide 23-

Canalicular Lacerations Upper Controversial (loss may not affect pt) Either repair laceration and ignore canaliculus, or Stent canaliculus (Mini Monoka) and repair lac Lower Usually needs to be repaired Repair within 24-48 hours Stent bicanalicular or monocanalicular Leave in for 3-6 months 8.0 or 9.0 vicryl to canaliculus
Slide 24-

ppt slide no 24 content not found
Slide 25-

ppt slide no 25 content not found
Slide 26-

Tissue Loss Explore wound thoroughly find all tissue Options Direct repair Tissue advancement Eg lateral canthotomy Advancement flaps Replace in layers Tarsoconjuntival flap and skin graft or vice versa
Slide 27-

Complications Lid margin notching If small may resolve, otherwise requires repair Lagophthalmos Due to scarring or tissue loss or septum into wound Try massage, may need scar release Hypertrophic scars May improve with time Consider steroid injection into 4-6/52 Infection Rare Tearing canalicular damage, lid malposition, pump failure Traumatic ptosis Myogenic or neurogenic
Slide 28-

Orbital Fractures
Slide 29-

Orbital #s classification Open or closed Internal (orbital skeleton), rim, complex (internal +rim) Type Blowout - typically 10-15mm behind rim, just medial infraorbital canal Tripod - disruption of zygoma at z-f and z-m sutures & along arch Enophthalmos, malar flattening, inf lat cantus displacement
Slide 30-

Pathogenesis of orbital floor blow-out fracture
Slide 31-

Evaluation of the orbit Eyelids Telecanthus - tendon disruption or nasoethmoidal #, suspect nld involvement Globe Displacement, proptosis Motility - ductions and diplopia, include FDT Pupil - APD, efferent, mydriasis Palpate Rim, crepitus, retropulsion Nerves - V1 & V2
Slide 32-

Periocular ecchymosis and oedema Infraorbital nerve anaesthesia Ophthalmoplegia - typically in up- and down- gaze (double diplopia) Enophthalmos - if severe Signs of orbital floor blow-out fracture
Slide 33-

Imaging CT Axial and coronal 3mm sections 1.5 through apex if suspect TON MRI No good - bone, metal FB Subdural optic n haematoma
Slide 34-

Investigations of orbital floor blow-out Right blow-out fracture with ‘tear-drop’ sign Restriction of right upgaze and downgaze Secondary overaction of left eye Coronal CT scan Hess test
Slide 35-

ppt slide no 35 content not found
Slide 36-

ppt slide no 36 content not found
Slide 37-

Surgical treatment of blow-out fracture (a) Subciliary incision Coronal CT scan following repair of right blow-out fracture with synthetic material (b) Periosteum elevated and entrapped orbital contents freed (c) Defect repaired with synthetic material (d) Periosteum sutured a b c d
Slide 38-

Zygoma Tripod Fractures Tripod fractures consist of fractures through: Zygomatic arch Zygomaticofrontal suture Inferior orbital rim and floor
Slide 39-

Zygoma Tripod FracturesImaging Studies Radiographic imaging: Waters, Submental and Caldwell views Coronal CT of the facial bones: 3-D reconstruction
Slide 40-

Zygoma Tripod FracturesClinical Features Clinical features: Periorbital edema and ecchymosis Hypoaesthesia of the infraorbital nerve Palpation may reveal step Concomitant globe injuries are common
Slide 41-

Medial wall blow-out fracture Signs Release of entrapped tissue Repair of bony defect Periorbital subcutaneous emphysema Ophthalmoplegia - adduction and abduction if medial rectus muscle is entrapped Treatment
Slide 42-

Anterior Segment Trauma
Slide 43-

Assessment History Forces involved Blunt, FB?, Penetrating Chemical Acid? Alkali? Contact allergy?
Slide 44-

Common Causes Abrasion Minor trauma - lash, finger Recurrent Epithelial Erosion Syndrome Plant Foreign body Grinding Penetrating Injury Hammering metal on metal Explosion Dirty / clean Blunt Fist Ball Bungy cord
Slide 45-

Examination Visual Acuity Skin/lids Evidence of severity of injury Evert lids ? Subtarsal FB Look for fine scratches on upper cornea Conjunctiva Laceration Look carefully for scleral injury beneath Sub conj hemorrhage
Slide 46-

ppt slide no 46 content not found
Slide 47-

Examination… Cornea Fluorescein stain - abrasion/wound Leak Infiltrate FB Anterior chamber Cells Hyphaema Hypopyon
Slide 48-

ppt slide no 48 content not found
Slide 49-

Examination…. Iris Transillumination defects Peaked pupil Dilated pupil Check for RAPD Lens Red reflex Stability IOP +/- angle
Slide 50-

Iris Trauma
Slide 51-

RAPD RAPD Relative afferent pupillary defect
Slide 52-

ppt slide no 52 content not found
Slide 53-

Corneal foreign body Grinding most common cause Usually do not need surgery Treatment Removal of foreign body with needle and/or burr Children may require GA
Slide 54-

Corneal Abrasion Common Usually resolve quickly Very painful initially Treatment Exclude other injuries Chloramphenicol ointment Patch 24 hours +/- pain relief / sleeping tablets
Slide 55-

ppt slide no 55 content not found
Slide 56-

Recurrent Epithelial Erosion History gives clue Often triggered by minor trauma Treatment Lubricants Bandage contact lens Epithelial debridement Tetracyclines Laser Phototherapeutic Keratectomy (PTK) Anterior Stromal Puncture
Slide 57-

ppt slide no 57 content not found
Slide 58-

Hyphaema
Slide 59-

ppt slide no 59 content not found
Slide 60-

Hyphaema Blunt injury Complications: Raised IOP Angle recession Corneal staining Rebleed Treatment Steroid Bed rest - debatable Frequent monitoring wrt IOP
Slide 61-

Angle recession
Slide 62-

Traumatic Uveitis Ranges from Mild to Severe Usually other injuries as well Treat as for normal uveitis but may not require long taper
Slide 63-

ppt slide no 63 content not found
Slide 64-

ppt slide no 64 content not found
Slide 65-

Vossius ring
Slide 66-

Iris Dialysis
Slide 67-

Lens subluxation
Slide 68-

Cataract
Slide 69-

ppt slide no 69 content not found
Slide 70-

ppt slide no 70 content not found
Slide 71-

ppt slide no 71 content not found
Slide 72-

ppt slide no 72 content not found
Slide 73-

ppt slide no 73 content not found
Slide 74-

ppt slide no 74 content not found
Slide 75-

Thank you for listening!