EYE TRAUMATHOLOGY Pavel Stodlka HIGH RISK OF TRAUMA

EYE TRAUMATHOLOGY Pavel Stodůlka

HIGH RISK OF TRAUMA in today’s daily life • Car accidents • industry

EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY 4. HEAT 5. CHEMICAL combined

EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY 4. HEAT 5. CHEMICAL combined

MECHANICAL 1. Structure - conj, cornea. . . 2. mechanism – foreign bodies - sharp x blunt 3. nonpenetrating x penetrating a) with foreign body b) without foreign body

CONJUNCTIVA & CORNEA 1. EROSION of cornea 2. RECURRENT EROSION 3. NONPENETRATING WOUNDS (ointment x suture) 4. PENETRATING WOUNDS (patching both eyes, suture)

SCLERA 1. PENETRATION a) sclera only b) sclera & cornea If corpus cilliaris also – severe bleeding If extends more than 5 mm behind limbus – retinal trauma

FOREIGN BODIES

FOREIGN BODIES 1. anamnesis (wind x hammer on chisel) 2. When foreign body suspected: CT

FOREIGN BODIES of CONJUNCTIVA & SCLERA u feels just like erosion

FOREIGN BODIES of CONJUNCTIVA & SCLERA Treatment: u Superficial - wipe out by cotton tipped stick - turn over eyelid u deeply driven – dig out by needle - clean rusty remnants - ATB ointment

MATERIAL of FOREIGN BODIES w ANAMNESIS - metalosis - siderosis (Fe) - chalkosis (Cu) blockage of enzymes in retinal rods & cones regular follow ups with ERG w CT

MATERIAL of FOREIGN BODIES u. METAL - magnetic x nonmagnetic Fe 75% u. NON METAL - inert x organic ( Fu, Cu & organic has to be removed )

THERAPY u SUTURE - ASAP u REMOVAL of foreign body - forceps - magnet u VITRECTOMIY u ATB

DOUBLE PENETRATION Foreign body gets in the eye and leaves it somewhere back. RISKS: endophtalmitis retinal detachment

MECHANICAL TRAUMA

MECHANICAL TRAUMA u SOLID ORBITAL RIM u SOLID EYE WALL

MECHANICAL TRAUMA CAN HIT ALL EYE STRUCTURES

EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY 4. HEAT 5. CHEMICAL combined

Pavel Stodůlka, MD, Ph. D stodulka@lasik. cz www. LASIK. cz BREAK !

EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY 4. HEAT 5. CHEMICAL combined

Radiation trauma • IR • UV • radioactive • lasers • solar

I R = heat u glassblower cataract - history

UV u ophtalmia fotoelectrica - welding - germicids - high mountains udestroys upain corneal epithelial cels 6 to 10 hours after (often come at night) ufluorescein dot like staining of cornea

UV Therapy: u lubricating ointment

RADIOACTIVE u industrial accidents u terrorism u tumor therapy

Radioactive Signs: u the same as UV exposure, but milder u lens at risk too (delayed cataract)

Radiactive Therapy: u lubricating ointment

LASERS u laser pointers u reflected laser beam (gogles)

SOLAR u SOLAR RETINOPATHY u UV exposure – corneal epithelial defects

EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY 4. HEAT 5. CHEMICAL combined

ELECTRICITY u eye burns u cataract

EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY 4. HEAT 5. CHEMICAL combined

HEAT u hot liquids u steam u molten metals

HEAT u temperature u time u volume

EYE TRAUMA CAUSES: 1. MECHANICAL 2. RADIATION 3. ELECTRICITY 4. HEAT 5. CHEMICAL combined

CHEMICAL u ACIDS: coagulation & necrosis u : ALKALINES colliquation & necrosis

CHEMICAL BURN most often and very dangerous: unslaked LIME burn

Chemical burn First aid: water & water removal of chemical remnants chemical neutralization

prim. MUDr. Pavel Stodůlka, Ph. D. stodulka@lasik. cz www. LASIK. cz