The ABCs of Ocular Trauma: Adapting a Familiar Mnemonic for Rapid Eye

Exam in the Pre-Ophthalmic Zone of Care

Authors: Christiaan F Kroesen, Matthew Snider, James Bailey, Adam

Buchanan, James W Karesh, Frank La Piana, Erin Seefeldt, Jo Ann
Egan, Robert A Mazzoli
Journal: Military Medicine, Volume 185
February - 2020
Link: https://academic.oup.com/milmed/article/185/Supplement_1/448/5740691
Duvan Alexis Linares Arenas

Objective
This article has like objective teach and adapter a mnemonic called the ABC for give a logic
order in the evaluation and management systematically of the ocular trauma, specifically
for the non-ophthalmologist or primary care providers (optometrist).
Thematic Analysis
For many primary care providers, the ocular injuries as appreciation of eye fragility and
subsequent paralysis in knowing how to proceed in this complex case. This led to that the
professional in medicine used a series of tools focused in the management of general
trauma. And in different support or courses, performed a mnemonic simple of ABCDE,
that allows answer to massive trauma or situations life-threatening.
The use of mnemonic ABC is very easy of remember in situations complex, for start the
process of attention. For this reason, they use the same in ocular exam. In this mnemonic
to have a logical order, the first element is the primordial for the attention and the latest
element is the action what to we take.
The visual acuity is the first element to consider, is the indicator the possible prognostic to
future visual result. If the visual acuity is very low, major is the priority in the attention.
Worst will be the damage in ocular structures. Also, must know the type of optotype o
visual acuity (Snellen, LogMar) and the visual acuity cualitive (count fingers, hand
movements, light perception, etc), that helping to actions the specialist to define the
treatment and actions surgery.
In the ocular trauma any person must know and understand as to size or quantify the
vision, obtaining the initial data of the evaluation pre ophthalmological and helping to the
patient to understand your situation.
The second element is to make an evaluation to both eyes and their structures. With a
light, start evaluation for the not injured eye. Always watching the external structures as
the eyelids, if are irregular and if there injure, then continue with the elements as
conjunctiva and sclera, looking hemorrhages or ruptures, also the cornea looking strange
bodies or irregularity, pupil reaction and position, blood in anterior chamber, all this
without touch the eye with strong. This helping to description of the initial findings.
Other point important is the evaluation of the structures adjoining or nurse, in case of the
ocular trauma must watch of the injury in face, orbital fractures, nasal and cranial. Also, if
there trauma in the eyelids must watch of lacrimal system or there trauma in orbital must
watch of breasts and brain. In the observation must watching the presence of contact
lenses, with motivation of not generate infection or complications in ocular surface.
There an aspect relevant and is the that no to make. For example, in case of ocular trauma
open, must've use antibiotic prophylactic, and not make ultrasound, induced nausea or
waltzalva maneuvers. Avoid magnetic resonance in case of body strange intraocular.
The ultimate step is ocular shield. The objective of this is to protect the eye until the
surgery attention. Worth noting, that this protection not touch the ocular globe and the
material is of metallic or plastic.
Conclusion
Such mnemonics can improve the prognosis of eye injuries in the field. Not only used for
hospital personal, if not also for any person that watching an ocular trauma and can
helping to better the visual and ocular prognostic of the patient.
Other conclusion is that to teach of the form very easy or simple is sometimes the best
form for understand and know themes that can to be so hard.
Contribution to Professional Practice
The information and experience about the ocular trauma help me to develop skills and to
be prepared for any case in any situation or place, and to be integral as professional of
visual and ocular care.

Contribute to The Practice Scenario

The topic of ocular trauma is very common in my clinical practice at the hospital Juan
bautista, weekly are many cases with this consult reason, for this must to have a guide
with the that we can management fast and effectively this. For this the contribution of
the article is very important in the management each case, helping to best visual and
ocular prognostic. I can give all for my patients, with each knowledge learned.