EYEEYE

TRAUMATTRAUMATHHOLOGOLOGYY

EYEEYE

TRAUMATTRAUMATHHOLOGOLOGYY

Pavel StodůlkaPavel Stodůlka

HIGH RISK OF TRAUMAin today’s daily life

• Car accidents• industry

HIGH RISK OF TRAUMAin today’s daily life

• Car accidents• industry

EYE TRAUMA CAUSES:EYE TRAUMA CAUSES:

1. MECHAN1. MECHANICALICAL

2. 2. RADIATIONRADIATION

3. ELE3. ELECCTRICTRICITYITY combinedcombined

4. 4. HEATHEAT

5. CHEMIC5. CHEMICALAL

EYE TRAUMA CAUSES:EYE TRAUMA CAUSES:

1. MECHAN1. MECHANICALICAL

2. 2. RADIATIONRADIATION

3. ELE3. ELECCTRICTRICITYITY combinedcombined

4. 4. HEATHEAT

5. CHEMIC5. CHEMICALAL

MECHANICAL MECHANICAL

1. 1. Structure Structure - - conj, corneaconj, cornea ... ...

2. mechanism – 2. mechanism – foreign bodiesforeign bodies

- - sharp sharp x x bluntblunt

3. n3. nononpenetrpenetratingating x penetr x penetratingating

a) a) with foreign bodywith foreign body

b) b) without foreign without foreign

bodybody

CONJUNCTIVA & CORNEACONJUNCTIVA & CORNEA

1. EROS1. EROSIONION of corneaof cornea

2. REC2. RECURRENT URRENT EROSEROSIONION

3. 3. NONPENETRATING WOUNDSNONPENETRATING WOUNDS

((ointmentointment x sutur x suturee))

4. 4. PENETRATING WOUNDSPENETRATING WOUNDS

((patching both eyespatching both eyes, sutur, suturee))

SCLERASCLERA

1. PE1. PENETRATIONNETRATION

a) a) sclera onlysclera only

b) b) sclera & corneasclera & cornea If corpus cilliaris also – severe bleedingIf corpus cilliaris also – severe bleeding

If extends more than 5mm behind limbus – retinal traumaIf extends more than 5mm behind limbus – retinal trauma

FOREIGN BODIESFOREIGN BODIES

FOREIGN BODIESFOREIGN BODIES

1. anamn1. anamnesisesis ((windwind x x hammer on chiselhammer on chisel))

2. 2. When foreign body suspected:When foreign body suspected:

CT CT

FOREIGN BODIESof CONJUNCTIVA & SCLERA

FOREIGN BODIESof CONJUNCTIVA & SCLERA

feels just like erosionfeels just like erosion

Superficial Superficial - - wipe out by cotton tipped stickwipe out by cotton tipped stick

- - turn over eyelidturn over eyelid

deeply drivendeeply driven – – dig out by needledig out by needle

- - clean rusty remnantsclean rusty remnants

- ATB - ATB ointmentointment

Treatment:

FOREIGN BODIESof CONJUNCTIVA & SCLERA

FOREIGN BODIESof CONJUNCTIVA & SCLERA

ANAMNANAMNESISESIS - metal - metalosisosis - sideros - siderosisis (Fe) (Fe)

- chalkos- chalkosisis

(Cu)(Cu) blockage of enzymes in retinal rods & blockage of enzymes in retinal rods &

cones cones

regular follow ups with regular follow ups with ERG ERG

CTCT

MATERIAL of FOREIGN BODIES

MATERIAL of FOREIGN BODIES

METALMETAL - magnetic x n - magnetic x nononmagneticmagnetic

Fe 75%Fe 75%

NON METALNON METAL - inert x organic - inert x organic

( Fu, Cu ( Fu, Cu && organic organic has to be removed has to be removed ) )

MATERIAL of FOREIGN BODIES

MATERIAL of FOREIGN BODIES

THERAPYTHERAPY

SUTURESUTURE - - ASAPASAP

REMOVAL of foreign bodyREMOVAL of foreign body - - forcepsforceps

- magnet- magnet

VITREVITRECCTOMITOMIYY

ATBATB

DOUBLE PENETRATIONDOUBLE PENETRATION

Foreign body gets in the eye Foreign body gets in the eye

and leaves it somewhere back.and leaves it somewhere back.

RIRISKSSKS: endo: endophphtalmititalmitiss

retinal detachmentretinal detachment

MECHANICAL TRAUMAMECHANICAL TRAUMA

MECHANICAL TRAUMAMECHANICAL TRAUMA

SOLIDSOLID ORBITAL RIMORBITAL RIM

SOLID EYE WALLSOLID EYE WALL

CAN HIT ALL EYE STRUCTURESCAN HIT ALL EYE STRUCTURES

MECHANICAL TRAUMAMECHANICAL TRAUMA

EYE TRAUMA CAUSES:EYE TRAUMA CAUSES:

1. MECHAN1. MECHANICALICAL

2. 2. RADIATIONRADIATION

3. ELE3. ELECCTRICTRICITYITY combinedcombined

4. 4. HEATHEAT

5. CHEMIC5. CHEMICALAL

BREAKBREAK ! !

Pavel Stodůlka,Pavel Stodůlka, MD, MD, PhDPhD

stodulkastodulka@@lasiklasik.cz.cz

www.LASIK.czwww.LASIK.cz

EYE TRAUMA CAUSES:EYE TRAUMA CAUSES:

1. MECHAN1. MECHANICALICAL

2. 2. RADIATIONRADIATION

3. ELE3. ELECCTRICTRICITYITY combinedcombined

4. 4. HEATHEAT

5. CHEMIC5. CHEMICALAL

Radiation traumaRadiation trauma

• IR• UV• radioactive• lasers• solar

glassblower cataractglassblower cataract - - historyhistory

I R = heat

oophphtalmia fotoelectrica - talmia fotoelectrica - weldingwelding

- germicid- germicidss

- - high mountainshigh mountains

destroys corneal epithelial celsdestroys corneal epithelial cels

pain 6 to 10 hours afterpain 6 to 10 hours after ((often come at nightoften come at night))

fluorescein dot like staining of corneafluorescein dot like staining of cornea

UV

lubricating ointmentlubricating ointment

UV

Therapy:

industrial accidentsindustrial accidents

terterrorismrorism

tumor therapytumor therapy

RADIOACTIVE

the same as UV exposure, but milderthe same as UV exposure, but milder

lens at risk too (delayed cataractlens at risk too (delayed cataract))

Radioactive

Signs:

lubricating ointmentlubricating ointment

Radiactive

Therapy:

laser pointerslaser pointers

reflected laser beamreflected laser beam ( (goglesgogles))

LASERS

SOLSOLARAR RETINOPAT RETINOPATHYHY

UV UV exposureexposure – – corneal epithelial defectscorneal epithelial defects

SOLAR

EYE TRAUMA CAUSES:EYE TRAUMA CAUSES:

1. MECHAN1. MECHANICALICAL

2. 2. RADIATIONRADIATION

3. 3. ELEELECCTRICTRICITYITY combinedcombined

4. 4. HEATHEAT

5. CHEMIC5. CHEMICALAL

eye burnseye burns

cataractcataract

ELECTRICITY

EYE TRAUMA CAUSES:EYE TRAUMA CAUSES:

1. MECHAN1. MECHANICALICAL

2. 2. RADIATIONRADIATION

3. ELE3. ELECCTRICTRICITYITY combinedcombined

4. 4. HEATHEAT

5. CHEMIC5. CHEMICALAL

hot liquidshot liquids

steamsteam

molten metalsmolten metals

HEAT

ttemperatureemperature

timetime

volumevolume

HEAT

EYE TRAUMA CAUSES:EYE TRAUMA CAUSES:

1. MECHAN1. MECHANICALICAL

2. 2. RADIATIONRADIATION

3. ELE3. ELECCTRICTRICITYITY combinedcombined

4. 4. HEATHEAT

5. 5. CHEMICCHEMICALAL

ACIDSACIDS::

coagulation & necrosiscoagulation & necrosis

:: ALKALINES ALKALINES

colliquation & necrosiscolliquation & necrosis

CHEMICAL

most often and very dangerousmost often and very dangerous::

unslaked LIME burnunslaked LIME burn

CHEMICAL BURN

water & water & waterwater & water & water

removal of chemical remnantsremoval of chemical remnants

chemical neutralizationchemical neutralization

Chemical burnFirst aid:

prim. MUDr. Pavel Stodůlka, Ph.D.prim. MUDr. Pavel Stodůlka, Ph.D.

stodulkastodulka@@lasiklasik.cz.cz

www.LASIK.czwww.LASIK.cz