Lecture 5 OCULAR INJURY

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Lecture 5
OCULAR INJURY

• Lecture is delivered by
• Ph. D., assistant of professor Tabalyuk Tetyana
  Anatolyivna

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Classification of ocular injury By conditions
agricultural, industrial, military, criminal
etc. By traumatic factor mechanical, termal,
chemical, radial, biological etc. By mechanism
A. blunt injuries (contusions) lid injuries,
orbital injuries, blunt injuries of the
eyeball B. penetrating trauma corneal, limbal,
scleral, corneo-scleral C. burns.

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• BLUNT INJURIES (contusions)
• lid injuries
• haematoma,
• laceration
• orbital injuries (fractures)
• blunt injuries of the eyeball
• corneal abrasion,
• scleral rupture,
• iridodyalisis,
• hyphaema,
• traumatic mydriasis,
• lens dislocation,
• haemophthalmos,
• commotio retinae,
• choroidal rupture,
• choroidoretinal haemorrhage,

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A small piece of iron has lodged near the margin
of the cornea
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Iridodyalisis
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left - subconjunctival haemorrhage right - blood
behind the cornea, inside the eye (hyphaema), the
iris has been bleeding
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Hyphaema blood in the anterior chamber
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Emergency in blunt injuries In
corneal abrasion antibacterial drops and
ointments and medicines, which rapid corneal
regeneration, for example, Tobramycini, Chinini
hydrochloride 1 (2 drops into affected eye 4-6
times a day), Ung.Floxali and Corneregel (under
lower eyelid 2-3 times a day). In
hyphaema haemophthalmos haemostatic therapy,
for example S. Dicinoni 12,5 2,0 i/m 2 times a
day, Tab. Ascorutini per os 3 times a day,
Vikasoli 0,015 per os 3 times a day, Sol. Ca
chloridi 3 in drops 4 times a day.
Foreign body of conjunctiva is removed by wet
cotton, pincet or injection needle. After
removing, antiseptics are instillated and
prescribed, for example S.Sulfacili Na or S.
Oftadec 4 times a day during 5-7 days.
Corneal foreign body is removed after
anaesthesia (S. Alcaini) by injection needle.
Antibacterial drops and ointments and medicines,
which rapid corneal regeneration are dropped and
prescribed, for example, S. Gentamycini 0,3 , S.
Taufoni 4 (2 drops into affected eye 4-6 times
a day), Ung.Tetracyclini and Actovegin gel (under
lower eyelid 2-3 times a day).
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• RETINAL DETACHMENT
• Rhegmatogenous
• 2. Exudative
• 3. Tractional
• Signs of detachment photopsia, metamorphopsia,
  shadow before eye, peripheral visual field loss
  controposite the localization of detached retina
• Surgical management
• Transscleral photocoagulation or criopexy
• Scleral buckling procedures
• Vitrectomy intraocular silicon oil or gas
  tamponade

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• Absolute signs of penetrating injury
• corneal or scleral wound
• intraocular foreign body
• extrusion of intraocular tissues (iris, choroid,
  vitreous, lens, etc) through the wound
• Relative signs of penetrating injury
• hypotonia
• pupil deformation
• changing of anterior chamber depth (flat or deep).

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Eye injury by impact of small plastic body
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Open eye injury, with iris prolapsed through the
cornea laceration. This type of injury needs
immediate eye care attention
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• Methods of localization of intraocular foreign
  body
• X-ray examination (metal foreign body - with
  special protesis of Komberg-Baltin nonmetal
  (glass) X-ray examination by Fogt)
• Ultrasound examination
• Complications of penetrating injury
• traumatic cataract
• traumatic iridocyclitis
• endophthalmitis
• panophthalmitis
• sympathetic ophthalmia (chronic fibro-plastic
  autoimmune iridocyclitis of the unaffected eye)
• Emergency in eye penetrating injury
• cleaning the wound,
• using antiseptics locally (i.e. S. Furacilini 1
  5000 or S. Laevomycetini 0,25 ),
• analgetics (S. Analgini 50 2,0 i/m),
• antibiotics systemically (i.e.Tab. Ofloxacini
  0,2 per os or S. Gentamycini sulfatis 4 1,0
  i/m),
• binocular dressing,
• transportation the patient in horizontal position
  into the special department

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CLASSIFICATION of BURNS I degree hyperemia of
conjunctiva superficial opacity
of cornea or corneal abrasion which
disappears without any changes II degree
superficial necrosis of conjunctiva
gray cloudy cornea (defect of epithelium
superficial
layers of stroma) III degree necrosis
of hole conjunctiva defect of
all corneal layers mat cornea IV degree
necrosis not only of conjunctiva, but also
sclera porcelain cornea
Emergency in eye burns removing of foreign
pieces especially in case of limes burn,
watering of the eye by water, Sol. Na isotonici
or S. Furacilini during 15-30 minutes, using of
antiseptics or antibiotics in drops (S. Dimexidi
10 , Ciloxan or Tobrex)
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