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Ocular trauma and ophthalmic emergencies

13 articles

Black eye

Black eye (periorbital hematoma, periorbital ecchymosis): bruising and swelling around the eye from face or head trauma, usually healing in days to 3 weeks; ice, acetaminophen, and checks for hyphema, orbital fracture, or skull fracture.

Choroidal rupture

Choroidal rupture: a traumatic break in Bruch's membrane, choriocapillaris, and RPE after blunt ocular trauma (ICD-11 NA06.61). Direct or indirect (countercoup) forms; main complication choroidal neovascularization treated with anti-VEGF.

Corneal abrasion

Corneal abrasion, a scratch of the corneal epithelium, is a common eye injury from trauma, foreign bodies, or contact lenses. Diagnosed with fluorescein and slit lamp; heals in 1-3 days; patching not recommended and antibiotic benefit unproven.

Endophthalmitis

Endophthalmitis: purulent intraocular inflammation of vitreous and aqueous, usually infectious; exogenous or endogenous. Treated with intravitreal vancomycin and ceftazidime, with vitrectomy guided by the 1995 EVS trial.

Eyelid trauma

Eyelid trauma is injury to eyelid tissues from blunt or penetrating forces, from black eyes to lacerations, and frequently accompanies eye or orbital injuries needing urgent evaluation.

Foreign body in conjunctival sac

Foreign body in conjunctival sac (ICD-10 T15.1, ICD-11 ND70.1): external material such as dust, metal, or glass lodged in the conjunctival sac between eyeball and eyelids; removed by irrigation or moist cotton applicator after anesthetic.

Foreign body on external eye

Foreign body on external eye (ICD-11 ND70): superficially adherent or embedded objects on the cornea or conjunctival sac, causing pain, tearing, and photophobia; managed by irrigation, swab, spud, or needle removal, antibiotics, and no patching.

Fracture of orbital floor

Fracture of orbital floor, or blowout fracture: break of the thin maxillary roof with intact inferior rim, causing diplopia, enophthalmos, and V2 numbness; repaired via transconjunctival, subciliary, subtarsal, or endoscopic approaches.

Hyphema

Hyphema is blood in the eye's anterior chamber, usually from blunt trauma; graded 0–IV (microhyphema to eight-ball), complicated by rebleeding, raised intraocular pressure, and corneal blood staining.

Injury of lens

Injury of lens is trauma to the crystalline lens of the eye, including traumatic cataract, subluxation, and dislocation, and a leading cause of vision impairment after ocular trauma.

Optic nerve avulsion

Optic nerve avulsion (ONA, Evulsio nervi optici) is traumatic disinsertion of optic nerve fibers at the lamina cribrosa after blunt ocular trauma; rare, causes permanent severe vision loss, no effective treatment.

Orbital cellulitis

Orbital cellulitis (postseptal cellulitis) is infection of the eye socket tissues behind the orbital septum, usually spreading from ethmoid or other paranasal sinusitis. Distinct from preseptal cellulitis; treated with IV antibiotics and surgery, it threatens vision and can cause cavernous sinus thrombosis.

Orbital fracture

Orbital fracture, including blowout fracture of the orbital floor or medial wall: break in the eye socket bones from blunt trauma, causing diplopia, enophthalmos, and V2 numbness; diagnosed by thin-cut CT, managed observationally or surgically.