![]() Topical antibiotics and artificial tears for mild ocular burns topical antibiotics, artificial tears, steroids, ascorbate, citrate drops, or amniotic membrane tissue for severe burns 6, 7ĭecreased vision conjunctival or corneal laceration subconjunctival hemorrhage ocular foreign body hyphema or shallow anterior chamber irregular shaped pupil or iris prolapseĪssess visual acuity, pupils, cornea, and anterior chamberĭecreased visual acuity, irregular shaped pupil, iris prolapse through corneal or scleral laceration, presence of penetrating foreign body Immediately irrigate eye with normal saline or lactated Ringer solution with at least 2 L of fluid immediately refer to an ophthalmologist 5 Nonarteritic causes: treat with digital massage, anterior chamber paracentesis, systemic acetazolamide, pentoxifylline (Trental), intra-arterial thrombolysisĪrteritic causes: treat with a high dose of systemic steroids 2 – 4Įye pain decreased vision conjunctival redness or ischemia corneal clouding or abrasionĪssess visual acuity examine cornea for clarity and conjunctiva for hyperemia determine the chemical agent Presence of a cherry-red spot in the fovea unilateral, painless vision loss of hand motion or light perception evaluate for stroke echocardiography electrocardiography carotid artery ultrasonography obtain erythrocyte sedimentation rate and C-reactive protein level immediately refer to an ophthalmologist 1 Systematic review of disease-oriented evidenceĪcute, painless loss of vision amaurosis fugax retinal whitening with foveal cherry-red spotĪssess visual acuity perform dilated funduscopic examination Patients with new symptomatic floaters, flashing lights, and visual field defect should be referred within 24 hours to an ophthalmologist for evaluation of a retinal tear or detachment. Prophylactic systemic antibiotics should be administered to patients to prevent endophthalmitis after a mechanical globe rupture or laceration. Patients with a suspected mechanical globe injury should have a metal shield placed over the eye, be given antiemetics, and be referred immediately to an ophthalmologist for surgical repair. Systematic review evaluating four heterogeneous clinical trials ![]() 1Ī chemical eye injury should be irrigated with normal saline or lactated Ringer solution until the ocular surface pH has normalized. ![]() Patients with a central retinal artery occlusion should receive a workup for stroke consisting of echocardiography, electrocardiography, and carotid artery ultrasonography. Patients with symptomatic floaters and flashing lights should be referred to an ophthalmologist for a dilated funduscopic examination to evaluate for a retinal tear or detachment. The eye should be covered with a metal shield until evaluation by an ophthalmologist. Physicians should administer prophylactic oral antibiotics after a globe injury to prevent endophthalmitis. A globe laceration or rupture is common in patients with a recent history of trauma from a blunt or penetrating object. Chemical injuries require immediate irrigation of the eye to neutralize the pH of the ocular surface. Patients with a central retinal artery occlusion require urgent referral for stroke evaluation and should receive therapy to lower intraocular pressure and vasodilating agents to minimize retinal ischemia. Family physicians should be able to recognize the signs and symptoms of each condition and be able to perform a basic eye examination. Central retinal artery occlusions, chemical injuries, mechanical globe injuries, and retinal detachments are eye emergencies that can result in permanent vision loss if not treated urgently.
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