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Ophthalmologic Procedures

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Handbook of Emergency Ophthalmology

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Abstract

Every emergency physician should be competent to handle ocular foreign bodies, ocular contamination with toxins, and retrobulbar hematoma causing increased intraocular pressure. Removal of a foreign body and corneal rust ring, including the equipment required, is described in this chapter. Eye irrigation to remove toxins and chemicals is explained, along with the use of a Morgan Lens or a nasal cannula. Retrobulbar hematoma causing increased intraocular pressure and optic nerve ischemia requires immediate lateral canthotomy, which is explained and illustrated.

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References

  1. George J, Ali N, Rahman NA, Joshi N. Spectrum of intra-ocular foreign bodies and the outcome of their management in Brunei. Int Ophthalmol. 2013;33(3):277–84.

    Article  PubMed  Google Scholar 

  2. Choovuthayakorn J, Hansapinyo L, Ittipunkul N, Patikulsila D, Kunavisarut P. Predictive factors and outcomes of posterior segment intraocular foreign bodies. Eye (Lond). 2011;25(12):1622–6.

    Article  CAS  Google Scholar 

  3. Mostafavi D, Olumba K, Shrier EM. Fiberglass intraocular foreign body with no initial ocular symptoms. Retin Cases Brief Rep. 2014;8(1):10–2.

    Article  PubMed  Google Scholar 

  4. Lapira M, Karl D, Murgatroyd H. Siderosis bulbi as a consequence of a missed intraocular foreign body. BMJ Case Rep. 2014. https://doi.org/10.1136/bcr-2013-202904.

  5. Bansal R, Jain AK, Sanghi G. Polyethylene foreign body on the cornea. Cornea. 2008;27(5):605–8.

    Article  PubMed  Google Scholar 

  6. Beyer H, Cherkas D. Corneal foreign body removal using a bent needle tip. Am J Emerg Med. 2012;30(3):489–90.

    Article  PubMed  Google Scholar 

  7. Lim LT, Al-Ani A, Ramaesh K. Simple innovative measures for ease of corneal foreign body removal. Ann Acad Med Singapore. 2011;40(10):469–70.

    PubMed  Google Scholar 

  8. Menghini M, Knecht PB, Kaufmann C, Kovacs R, Watson SL, Landau K, Bosch MM. Treatment of traumatic corneal abrasions: a three-arm, prospective, randomized study. Ophthalmic Res. 2013;50(1):13–8.

    Article  PubMed  CAS  Google Scholar 

  9. Jayamanne DG, Bell RW. Non-penetrating corneal foreign body injuries: factors affecting delay in rehabilitation of patients. J Accid Emerg Med. 1994;11(3):195–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Austin PE, Ljung M, Dunn KA. A new model for teaching corneal foreign body removal. Acad Emerg Med. 1995;2(9):831–4.

    Article  PubMed  CAS  Google Scholar 

  11. Cassara M, Tenner KR, Borheck A. The incredible embeddable egg: an inexpensive model for simulating corneal foreign bodies and teaching slit lamp-associated skills. Acad Emerg Med. 2011;18(5 Suppl. 1):S255.

    Google Scholar 

  12. Sharma M, McLeod SL, Shah A. The use of antibiotics in corneal abrasion and corneal foreign bodies in the emergency department. Can J Emerg Med. 2013;15:S4.

    Google Scholar 

  13. Brissette A, Mednick Z, Baxter S. Evaluating need for close follow-up after removal of a noncomplicated corneal foreign body. Cornea. 2014;33(11):1193–6.

    Article  PubMed  Google Scholar 

  14. Weaver CS, Terrell KM. Evidence-based emergency medicine. Update: do ophthalmic nonsteroidal anti-inflammatory drugs reduce the pain associated with simple corneal abrasion without delaying healing? Ann Emerg Med. 2003;41(1):134–40.

    Article  PubMed  Google Scholar 

  15. Connor AJ, Severn P. Use of a control to aid pH assessment of chemical eye injuries. Emerg Med J. 2009;26(11):811–2.

    Article  CAS  PubMed  Google Scholar 

  16. Spector J, Fernandez WG. Chemical, thermal, and biological ocular exposures. Emerg Med Clin North Am. 2008;26(1):125–36.

    Article  PubMed  Google Scholar 

  17. Wade RG, Peacock D. Bilateral eye irrigation: a simple and effective hands-free technique. Eur J Emerg Med. 2014;21(4):305–7.

    Article  PubMed  Google Scholar 

  18. Chau JP, Lee DT, Lo SH. A systematic review of methods of eye irrigation for adults and children with ocular chemical burns. Worldviews Evid Based Nurs. 2012;9(3):129–38.

    Article  PubMed  Google Scholar 

  19. Kuckelkorn R, Schrage N, Keller G, Redbrake C. Emergency treatment of chemical and thermal eye burns. Acta Ophthalmol Scand. 2002;80(1):4–10.

    Article  PubMed  Google Scholar 

  20. Ikeda N, Hayasaka S, Hayasaka Y, Wantanabe K. Alkali burns of the eye: effect of immediate copious irrigation with tap water on their severity. Ophthalmologica. 2006;220(4):225–8.

    Article  PubMed  CAS  Google Scholar 

  21. Jones JB, Schoenleber DB, Gillen JP. The tolerability of lactated Ringer’s solution and BSS plus for ocular irrigation with and without the Morgan therapeutic lens. Acad Emerg Med. 1998;5(12):1150–6.

    Article  PubMed  CAS  Google Scholar 

  22. Saidinejad M, Burns MM. Ocular alternatives in pediatric emergency medicine. Pediatr Emerg Care. 2005;21(1):23–6.

    Article  PubMed  Google Scholar 

  23. Duffy B. Managing chemical eye injuries. Emerg Nurse. 2008;16(1):25–9.

    Article  PubMed  Google Scholar 

  24. Bixby S. Dr. Morgan Bio. The morgan lens. MorTan, Inc. http://morganlens.com/?s=Dr.+Morgan. Accessed 7 Oct 2016.

  25. Centers for Disease Control and Prevention. Exposure to blood. 2003. http://www.cdc.gov/hai/pdfs/bbp/exp_to_blood.pdf. Accessed 7 Oct 2016.

  26. Mohammadi F, Rashan A, Psaltis A, Janisewicz A, Li P, El-Sawy T, Nayak JV. Intraocular pressure changes in emergent surgical decompression of orbital compartment syndrome. JAMA Otolaryngol Head Neck Surg. 2015;141(6):562–5.

    Article  PubMed  Google Scholar 

  27. Messman AM. Ocular injuries: new strategies in emergency department management. Emerg Med Pract. 2015;17(11):1–21.

    PubMed  Google Scholar 

  28. Carrim ZI, Anderson IW, Kyle PM. Traumatic orbital compartment syndrome: importance of prompt recognition and management. Eur J Emerg Med. 2007;14(3):174–6.

    Article  PubMed  Google Scholar 

  29. Colletti G, Fogagnolo P, Alleyi F, Rabbiosi D, Bebi V, Rossetti L, Chiapasco M, Felisati G. Retrobulbar hemorrhage during or after endonasal or periorbital surgery: what to do, when and how to do it. J Craniofac Surg. 2015;26(3):897–901.

    Article  PubMed  Google Scholar 

  30. See A, Gan EC. Orbital compartment syndrome during endoscopic drainage of subperiosteal orbital abscess. Am J Otolaryngol. 2015;36(6):828–31.

    Article  PubMed  Google Scholar 

  31. Hurst J, Johnson D, Campbell R, Baxter S, Kratky V. Orbital compartment syndrome in a burn patient without aggressive fluid resuscitation. Orbit. 2014;33(5):375–7.

    Article  PubMed  Google Scholar 

  32. Sullivan SR, Ahmadi AJ, Singh CN, Sires BS, Engray LH, Gibran NS, Heinbach DM, Klein MB. Elevated orbital pressure: another untoward effect of massive resuscitation after burn injury. J Trauma. 2006;60(1):72–6.

    Article  PubMed  Google Scholar 

  33. Nemiroff J, Baharestani S, Juthani VV, Klein KS, Zoumalan C. Cirrhosis-related coagulopathy resulting in disseminated intravascular coagulation and spontaneous orbital hemorrhages. Orbit. 2014;33(5):372–4.

    Article  PubMed  Google Scholar 

  34. Sia PI, Sia DIT, Scroop R, Selva D. Orbital compartment syndrome following transvenous embolization of carotid-cavernous fistula. Orbit. 2014;33(1):52–4.

    Article  PubMed  Google Scholar 

  35. Colak S, Erdogan MO, Duran L, Kati C, Senel A. Retrobulbar hemorrhage associated with subarachnoid hemorrhage. J Exp Clin Med. 2013;30(4):373–5.

    Article  Google Scholar 

  36. Haizul IM, Kiet-Phang L, Kalthum UMN. Reversal of blindness in haemorrhagic orbital varices by prompt orbital decompression. J Neurooncol. 2012;36:45–6.

    Google Scholar 

  37. Prodhan P, Noviski NN, Butler WE, Eskandar E, Ellen Grant P, Whalen MJ. Orbital compartment syndrome mimicking cerebral herniation in a 12-year-old boy with severe traumatic asphyxia. Pediatr Crit Care Med. 2003;4(3):367–9.

    Article  PubMed  Google Scholar 

  38. Sun MT, Chan WO, Selva D. Traumatic orbital compartment syndrome: importance of the lateral canthotomy and cantholysis. Emerg Med Australas. 2014;26(3):274–8.

    Article  PubMed  Google Scholar 

  39. Lima V, Burt B, Leibovitch I, Prabhakaran V, Goldberg RA, Selva D. Orbital compartment syndrome: the ophthalmic surgical emergency. Surv Ophthalmol. 2009;54(4):441–9.

    Article  PubMed  Google Scholar 

  40. Rowh AD, Ufberg JW, Chan TC, Vilke GM, Harrigan RA. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome. J Emerg Med. 2015;48(3):325–30.

    Article  PubMed  Google Scholar 

  41. Iserson KV, Luke-Blyden Z, Clemans S. Orbital compartment syndrome: alternative tools to perform a lateral canthotomy and cantholysis. Wilderness Environ Med. 2016;27(1):85–91.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA

    Walter Green MD

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  1. Walter Green MD
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Editor information

Editors and Affiliations

  1. Department of Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA

    Brit Long

  2. Department of Emergency Medicine, The University of Texas, Southwestern Medical Center, Dallas, Texas, USA

    Alex Koyfman

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Green, W. (2018). Ophthalmologic Procedures. In: Long, B., Koyfman, A. (eds) Handbook of Emergency Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-78945-3_13

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  • DOI: https://doi.org/10.1007/978-3-319-78945-3_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-78944-6

  • Online ISBN: 978-3-319-78945-3

  • eBook Packages: MedicineMedicine (R0)

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