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  • pg 1
									Eye Injury Assessment

    Chapter 16, p. 567
Clinical Anatomy--
p.567



 Bony anatomy
   orbital
   frontal bone
   zygomatic bone
 The Eye
   globe
   conjunctiva
   cornea
   lens
   retina
Clinical Anatomy--p.570

Muscular anatomy--
 fig. 16-4
  rectus group
  oblique group
Visual Acuity--
p. 570



Snellen chart
Acuity:
    Emmetropia--20/20
    Myopia--near-sighted
    Hypermetropia--far-
     sighted
    Diplopia
Injury Assessment:
History--p.570

 Location of pain (globe,
  lid, etc)
 Injury Mechanism
  (laceration, trauma,
  irritant)
 Foreign objects(?)--sand,
  fingers, sweat, etc.
 Prior visual records
 corrected/uncorrected
  vision?
Injury Assessment:
Observation--p.572

Nystagmus
Deformity--
  bony or soft tissue
   derangement
  periorbital discoloration--
   orbital hematoma (Black
   Eye)
Symmetry--globe
 placement (pupils)
Observation--

eyelids   p.572

  signs of infection:
     stye
     chalazion
  symmetry (resting and
   active)
cornea--
  discoloration
  hyphema--p.573
Observation--
p.573



conjunctiva--                  pupil--
   conjunctivitis                symmetry (anisocoria)
    (pinkeye)                        size & placement
   subconjunctival               shape (round)
    hemorrhage(p574-fig.16-9)     reaction (PEARL)
Pathologies-

 Blow-out fracture
 Corneal abrasion
 Iritis
 Detached retina
 Conjunctivitis
 Foreign Bodies
Blow-out fracture-
p.576



Table-16-5, p.578
Observation
   orbital lacerations?
   dec. ROM possible
   periorbital edema &
     ecchymosis
 Palpation/Examination
   periorbital tenderness
   neuro. Sensory eval.
Hyphema--
p.573



Sign of internal
 damage to globe
Blood pooling in
 anterior chamber of
 eye
acute or delayed
Refer to physician
 immediately
Corneal abrasion--
p.577



 Table 16-3, p. 578
 acute onset--intense pain
 no obvious abrasion
  although redness possible
 possible photophobia
 fluorescein strips for
  testing
 blurred vision possible 2°
  injury or tears/watering
Iritis--
p.579



Table 16-7, p. 580
Acute traumatic onset
photophobia common
sluggish pupil
anisocoria possible
Detached retina--
p.579



Trauma/jarring to the
 head
c/o “curtain” effect
   visual field narrows
   reports flashes, blind
    spots, or halos
Conjunctivitis--
p. 580



 Table 16-9, p. 581
 “pinkeye”;infection
 acute onset
 redness, lid edema
 vision disturbances
 HIGHLY contagious
 Do NOT allow contact
  lenses
 refer to physician
Foreign Bodies--
p.580



 Troublesome, but easily
  treated
 proper treatment avoids
  abrasions, impalement, &
  infection
 removal should not cause
  further injury
   flush eye with saline
   dry gauze
   natural tearing
   avoid dry cotton
Special Testing

 Snellen Test
 Reflexes
   Blink
   Pupillary Reaction test--p.
    575
   Direct light reflex
   Consensual light reflex

								
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