trauma orbital
DESCRIPTION
trauma pada mataTRANSCRIPT
ORBITAL TRAUMA
Princesa Sofia 09-80Novina Firlia 09-83Deski Shindy C.P Made 09-85
Anatomy
Outline
1. Assessment of Trauma2. Types of injury
Peri-ocularAnterior segmentPosterior segment
3. Chemical injury
Epidemiology● 40% of monocular blindness is related to trauma The leading cause of monocular blindness● 70-80% injured are male● Age range is 0-100 yrs but most are young average age 30yr
(American academy of opthalmology april 2011)
Sources of Injury Blunt objects - 30-40%
rocks, fists, branches, champagne corks Motor Vehicle Injuries - 9% Play or sports - 1/3
golf/squash balls, shoulder/elbow, bats/racquets, horse
Falls - 4% Sharp objects – 18%
(American academy of opthalmology april 2011)
Definition
Eye trauma refers to damage caused by a direct blow to the eye that the trauma may affect not only the eye but the surrounding, including adjacent tissue and bones structure.(Bausch+Lomb)
Symptoms of Eye trauma
• Bruising• Cuts to the eyelid• Eye redness• Swelling• Bleeding between the cornea and iris, known as
hyphema• Retinal detachment• Blurred or cloudy vision• Double vision
Chemical Burn
Thermal Burn
Examples: Curling Iron Burn. UV Irradiation. Sun Viewing. X-ray Radiation.
Orbital Fracture/Periorbital Contusion Hematoma
Fracture fragments and herniation of periorbital tissues into the maxillary sinus
Pathogenesis of orbital floor blow-out fracture
Assessment History
Detailed as possible Time and nature of injury
Missile, blunt, chemical etc
Past ocular history Previous VA and lid function remember trauma is a recurrent pathology
Med Hx tetanus, Anticoagulation
Examination Tissue loss Layers of lid Lid Margin Canaliculi Prolapsed fat/septal involvement Levator function Lagophthalmos Canthal tendon/angle
Image
CT - fine cuts orbits If unable to determine posterior aspect of
wound If suspect orbital fracture/ other injuries
Repair
TimingIdeally within 12-24 hours of injuryCan delay up to 1 week
Patient factorsGross swelling
– Ice packs to reduce– Steroid
AnaesthesiaGA / LA
Repair: General Principles
Clean woundMinimal debridementCareful handling of tissuesCareful alignment of anatomy
Lid margins, lash line, skin folds etcClose in layers