Trauma
Case Presentation
A 30-year-old builder was using a hammer to hit a steel chisel. He felt something hit his eye and the vision became blurred with slight pain and photophobia since one hour. He is fit and well and there is no history of medical problems.
On examination by his GP the vision was reduced to 6/12. A fluorescein-staining lesion was seen on the cornea but this appeared Seidel’s negative. A small hyphaema was seen in the anterior chamber, and in the red reflex observed with a direct ophthalmoscope a well delineated lens opacity was seen. The retina appeared normal.
Clinical Image
Never remove foreign body from eye in emergency room, only in operating room in sterile conditions
Site of FB
- vitreous most common site
- Cornea-Ac-Iris-Lens-Retina
Removal of intraocular foreign body
Trial through magnetic attraction - if magnetic it will be attracted and removed from vitreous then suture sclerematomous C Gr - try two times only third stop. (Large fibrosis or non magnetic may cause this) - suture the wound then refer vitreous retinal surgeon
Chemical reactions
Siderosis: FE rust Chaliosis: CU
Alkaline is worst - results in rapid penetration of ocular tissue Acidic = coagulation of protein
Differential Diagnosis
- acute painful eye
Investigations
Treat Irrigate eye with normal saline at least 15 minutes In chemical burn then refer
Do not cover and refer to ophthalmologist - first clean with normal saline then cover and refer - only in mechanical trauma to cover and refer