Ocularemerg
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first aids of the eyes
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Ocularemerg
- 1. Ocular Emergencies Lianne Beck, MD Emory Family Medicine
- 3. Anatomy of the Eye www.jaapa.com
- 7. Estimating Anterior Chamber Depth
- 14. Merck Manual Online Medical Library: http://www.merck.com/mmpe/sec09/ch098/ch098j.html#CACBGIHG
- 24. Linear epithelial defects suggestive of foreign body under the eye lid
- 41. Quick Snappers
- 42. Hordeolum (Sty)
- 43. Chalazion
- 44. Chemosis
- 46. Pinguecula
- 47. Pterygium
- 49. Questions?
Notes de l'éditeur
- Important to determine if patient knows direction of light, as this ensures an intact macula (in retinal detachment for example).
- An attack of acute angle-closure glaucoma in predisposed persons can occur as a result of dim lighting or use of certain medications (e.g., dilating drops, anticholinergics, antidepressants). Medications such as sulfa derivatives and topiramate (Topamax) can cause swelling of the ciliary body and secondary angle closure.
- Positive predictive value = probability of disease among patients with a positive test Negative predictive value = probability of no disease among patients with a negative test
- KEY ED MANAGEMENT : If patient history worrisome for foreign body, but nothing is visualized on initial exam, EVERT the eyelids. Many foreign bodies become lodged in upper lid and are not visible on initial exam.
- Choices of Abx: erythromycin ointment and bacitracin-polymyxin B ointment (e.g., Polysporin ophthalmic ointment), as well as combination solutions such as trimethoprim-polymyxin B (e.g., Polytrim). 10 percent sulfacetamide solution (Bleph-10) bacteriostatic agent has weak to moderate activity against many gram-positive and gram-negative organisms, including those that commonly cause conjunctivitis. Fluoroquinolones, which include ciprofloxacin (Ciloxan), ofloxacin (Ocuflox) and norfloxacin (Chibroxin) generally should be reserved for use in more severe ocular infections, including bacterial keratitis.
- A systematic review of several randomized controlled trials concluded that there is currently not enough evidence to recommend one treatment over another for acute CRAO.