University of the East Ramon Magsaysay Medical Center

DEPARTMENT OF OPHTHALMOLOGY

Feedback on
Ocular Trauma
and
Emergencies
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
DISCLAIMER
•This power point presentation is
made for educational purposes
only and is intended to be used for
UERM Medical Students, Clinical
Clerks or Post-Graduate Interns.

•Slides may contain sensitive

photos of actual patients. Please
refrain from taking a snapshots or
recording the presentation unless
allowed by the speaker.

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

OUTLINE / OBJECTIVES
At the end of the module, the student should be able to:
• Evaluate the common ocular and orbital injuries
• Determine problems that would require prompt attention of
an ophthalmologist
• Institute initial therapy during situations of ocular
emergencies such as chemical burns.

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 1
• 43 y/o,M
• CC: pool solution
splashed on the right
eye

Q. What will you do?

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 1
• TRUE emergency = therapy within
minutes
• Alkali vs Acid Burn
• Alkali = greater damage, penetrate ocular
tissues

• Immediate Management
• IRRIGATION performed for 20 minutes at
least 2 liters of available aqueous solution
• Normal saline solution
• Lactated Ringers solution

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 2
• 32 year old man
• CC: painful, red eye
• HPI :
• (+) trauma on the eye while
riding a bike
• washed eye – NO relief

Photo by Wallace Chuck from Pexels

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 2: What is the best way to
examination under the upper lid?

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 2: If he sustained a corneal abrasion and no foreign
body is identified, what would you expect on examination?

• Increased tearing
• Decreased vision
• Epithelial defect/staining

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 2: How will you treat
corneal abrasion?
• NEVER prescribe topical anesthetic
• Eye patch to keep the lid closed
• Option: Bandage contact lens

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 2: If you suspect perforation of the eye,
what signs do expect to see?
• Irregular shape pupils
• Shallow anterior chamber
• Uveal tissue prolapse
• Hyphema

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 3
• 18 year-old construction worker
• CC: pain, tearing, sensitivity to light and blurred vision on the right
eye
• HPI : (+) hammering on cement wall, (+) FB on the right eye
• PE:
• VA OD 20/50 OS 20/20
• Conjunctival hyperemia, OD
• Peaked pupils

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 3: What is the most appropriate initial
management?
• Protective shield
• CT scan for ocular/orbital foreign body
• URGENT referral to an Ophthalmologist

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 3: TRUE case

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 4
(+) MVA
(+) bloody face

Q1. What would you do? What would you avoid?

Q2. While cleansing, you find cut in the eyelid. It seems easy to stitch
but the eyelids are swollen and patient cannot open his eyes. What
next? Do you stitch the eyelid
Q3. If the eye is normal, How should you analyze the problem of eyelid
laceration?

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Case 4: Lid laceration

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

 SUMMARY
• Know your limits
• AVOID digital palpation of the globe
• In a patient with chemical burn, immediate irrigation is crucial
• Traumatic abrasion generally located in the central or inferior cornea

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

QUESTIONS?

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 Thank You!
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY