Orbital trauma: Difference between revisions

(Created page with "==Background== *Must assess: **Visual acuity **Anterior chamber **Integrity of globe *Use paperclip or eyelid speculum to open swollen eyes ==Clinical Features== #Anterior chamb...")
 
(clinical exam for eye trauma)
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**Anterior chamber
**Anterior chamber
**Integrity of globe
**Integrity of globe
**Pupil shape and reactivity
*Use paperclip or eyelid speculum to open swollen eyes
*Use paperclip or eyelid speculum to open swollen eyes


Revision as of 20:07, 31 December 2013

Background

  • Must assess:
    • Visual acuity
    • Anterior chamber
    • Integrity of globe
    • Pupil shape and reactivity
  • Use paperclip or eyelid speculum to open swollen eyes

Clinical Features

  1. Anterior chamber is flat
    1. Ruptured globe is certain
    2. Stop the exam; place eye shield, consult ophtho
  2. Hyphema
    1. Evidence of significant trauma; consult ophtho
  3. Extra-ocular movements
    1. Restricted upgaze or lateral gaze suggests Orbital Fracture w/ entrapment
      1. Obtain CT face
  4. Orbital Rim
    1. Feel for step-off
  5. Sensation
    1. Test along distribution of inf orbital nerve (below eye and ipsilateral side of nose)

Diagnosis

  1. Slit-lamp exam w/ fluorescein
    1. Check for:
      1. Abrasion
      2. Laceration
      3. Foreign body
      4. Hyphema
      5. Iritis
        1. Pupil may be constricted or dilated
      6. Lens dislocation
      7. Globe rupture
        1. +Seidel test
        2. Full-thickness laceration

Disposition

  1. Ophtho in 48hr if vision and ocular anatomy are preserved

See Also

Retrieved from "https://www.wikem.org/w/index.php?title=Orbital_trauma&oldid=15615"