Ophtha

Corneal ulcer vs abrasion vs scar

Eyelid laceration: when to refer to ophtha

Eye trauma: Causes of decreased visual acuity

Globe rupture: signs of

Corneal ulcer vs abrasion vs scar

White patch in cornea

- if it stains: corneal ulcer

- if it doesn't: corneal scar (old abrasion)

No white patch and stains: corneal abrasion

Eyelid laceration: when to refer

If there is extension to:

1. lid margin

2. upper lid

3. lacrimal system (medial 1/3 of the lid)

Globe rupture

Globe rupture

- signs of occult Globe rupture

1. Seidel's sign

2. Scleral smudge: sclera has been denuded, choroid is exposed

3. Shallow or deep anterior chamber

4. Significant vision loss

5. Bloody and Bulging Chemosis: almost palpable and extends up to cornea (subconj is flat and redness will stop/clear before cornea)

6. Peaked or Teardrop pupil

7. Hyphema

8. Hypotonia: flaccid globe

9. vitreous hemorrhage: retinal blood vessels rupture and bleed into the vitreous humor

Chalazion vs Hordeolum/Stye

Chalazion = chronic few weeks, sterile inflammation of these glands Zeiss or Meibomian (deeper); no erythema
- lipogranulomatous reaction
- Tx: may need to be removed by Ophtha
- recurrent chalazion, may be Ca, KIV Biopsy

Hordeolum = Stye, acute infection (usually Staph) of Zeiss or Meibomian with surrounding erythema
- internal Hordeolum = Meibomian of the upper lid
- external Hordeolum = Zeiss or Meibomian of the lower lid margin
- Tx: ?antibiotic drop/ointment
- may transform to chalazion

Tx: Warm compress 10 minutes 5x a day for both
If systemic signs, fever, spreading swelling, pain on moving eye = maybe dealing with orbital or periorbital cellulitis

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