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Penetrating eye injury

Ocular trauma is the one cause of the acute visual loss. Even a slight defect of the globe integrity can have negative consequences. We can distinguish two types of mechanical ocular trauma: closed (contusion, lamellar laceration) and open (penetration, perforation). In the case of the penetrating ocular trauma is the corneoscleral wall damaged in its whole thickness. The anaesthesia in eye surgery has its very own specifics, that anaesthetist need to care about. This interactive algorithm describes principles of the care for the eye trauma, beggining from the first aid up to the eye surgery.

Author: Jitka Chlupová, MD, Adam Lužák, Lukáš Majerčák

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: ocular penetration | oculocardiac reflex | intraocular pressure

Educational evel: Undergraduate level | Graduate

Ocular trauma is the one cause of the acute visual loss. Even a slight defect of the globe integrity can have negative consequences. We can distinguish two types of mechanical ocular trauma: closed (contusion, lamellar laceration) and open (penetration, perforation). In the case of the penetrating ocular trauma is the corneoscleral wall damaged in its whole thickness. The anaesthesia in eye surgery has its very own specifics, that anaesthetist need to care about. This interactive algorithm describes principles of the care for the eye trauma, beggining from the first aid up to the eye surgery.


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Review

Reviewer:

Bronislav Stibor, MD, PhD, Oberarzt, ICU, Landesklinikum Baden bei Wien, Austria

Anesthesia in ophthalmology is not usually the most challenging anesthetic field. Nevertheless, it has its specific features, and failure  to recognize and appreciate them may have fatal consequences for the patient's vision. The tutorial algorithm describes the course of the correct treatment of the patient from the pre-hospital laic care to the management of the late complications of the penetrating eye injury from an anesthesiological point of view. The  proposed decision algorithms are logical, and in addition to the correct procedure, also the most common mistakes are discussed, with an explanation of the consequences of an improper treatment. The model scenarios are very close to the real situations, such as every anesthesia practitioner may encounter when dealing with an ophthalmology patient. Practicing the right course of action is the best preparation for a real situation. Unlike the learning scenario, life can not usually "go a step back".

publikováno: 25.5.2017 | last modified on: 16.5.2018