Eye injury physical examination

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Eye injury Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

Overview

The goal of investigation is the assessment of the severity of the ocular injury with an eye to implementing a management plan as soon as is required. The usual eye examination should be attempted, and may require a topical anesthetic in order to be tolerable.

The first step is to assess the external condition of the eye and orbit, and check for perforations, hyphema, uveal prolapse, or globe penetration. If the pupil is teardrop-shaped, and the anterior chamber is flat, this is almost always a perforating injury of the cornea or limbal area.

Depending on the medical history and preliminary examination, the primary care physician should designate the eye injury as a true emergency, urgent orsemi-urgent.

Emergency

An emergency must be treated within minutes. This would include chemical burns of the conjunctiva and cornea.

Urgent

An urgent case must be treated within hours. This includes penetrating globe injuries; corneal abrasions or corneal foreign bodies; hyphema (must be referred)' eyelid lacerations that are deep, involve the lid margin or involve the lacrimal canaliculi; radiant energy burns such as arc eye (welder's burn) or snow blindness; or, rarely, traumatic optic neuropathy.

Semi-urgent

Semi-urgent cases must be managed within 1-2 days. They include orbital fractures and subconjunctival hemorrhages.

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