Eyelid Bruises And Tear Injuries

The consequences of blunt eye trauma ranging from eyelid to Orbitaverletzung.

The consequences of blunt eye trauma ranging from eyelid to Orbitaverletzung. Eyelids eyelid bruising ( “black eye”) are more of a cosmetic than a clinical problem, although sometimes accompanied by a heavy Korneaverletzung that should not be overlooked. Uncomplicated contusions be treated with ice packs in the first 24-48 hours in order to inhibit the swelling. Are then placed on hot pads that support the absorption of the hematoma. Small Lidrisse that do not relate to the lid margin or Lidknorpel can with 6-0 or 7-0 nylon threads (or, in children, with easy absorbable suture) are sewn. Lidrandverletzungen are best served by an ophthalmologist to ensure the correct position of the lid and prevent formation of a gap in the contour. Eyelid Accidents complexes which affect the central part of the lower eyelid or the upper eyelid (with possible involvement of the lacrimal duct), penetrating injuries, and those with ptosis, as well as injuries to leakage of the orbital fat or participation of the lid plate should be also supplied by an ophthalmologist. Eyeball trauma can lead to these consequences: (. Retinal detachment) bleeding of the conjunctiva, the anterior chamber and vitreous retinal hemorrhage, edema or detachment lens glaucoma globe rupture (tear) The investigation, in a massive lid or in cracks be difficult iris lesions, cataract Displaced , Nevertheless, the lid should be opened (which must be taken to ensure that no pressure is exerted on the eyeball) to examine the eye as much as possible – unless the need for an immediate eye surgery is obvious. In this case, must take place as soon as possible an investigation by an ophthalmologist. At least the following factors should be considered: is performed as a lateral canthotomy method demonstrated by Matthew A. Stephens, MD, Faculty Walter A. Schrading, MD, FACEP, faculty supervisor WellSpan York Hospital Emergency Medicine Residency Program York, PA carcass samples courtesy of Maryland State Anatomy Board DHMH Univ Filmed on location in the School of Medicine, Anatomical Services Division. Maryland var model = {videoId: ‘4616538326001’ playerId: ‘H1xmEWTatg_default’ imageUrl: ‘http://f1.media.brightcove.com/8/3850378299001/3850378299001_4616550903001_vs-564a4edae4b071da277576b3-782203293001.jpg?pubId=3850378299001&videoId=4616538326001 ‘, title:’ As a lateral canthotomy is carried out ‘, description:’ ‘credits’ method demonstrated by Matthew A. Stephens, MD, Faculty Walter A. Schrading, MD, FACEP, faculty supervisor WellSpan York hospital Emergency Medicine Residency Univ Program York, PA carcass samples provided by the Maryland State Anatomy Board DHMH Filmed on location in the School of Medicine, Anatomical Services Division. Maryland ‘, hideCredits: true hideTitle: false, hideDescription: true loadImageUrlWithAjax: true}; var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘video element panel..’); ko.applyBindings (model, panel.get (0)); Visual acuity (evaluation of visual acuity) pupil shape and reactions Extraocular movements anterior chamber depth or bleeding red reflex assessment of visual acuity in descending order of acuity vision is evaluated by reading a Snellen eye chart counting fingers motion detection (z. B. gesture seen) perception of light missing light perception It may be an analgesic or after the permission at a surgical procedure, an anxiolytic be added to facilitate the investigation. The eyelid can be opened under very careful and behutsamem use of Lidretraktors or a lid speculum. When a commercial instrument is not available, the eyelids with makeshift retractor can be made by a paper clip will be bent into an S-shape, and then the U-shaped ends are bent at an angle of 180 °. Bulbusverletzungen should be suspected if any of the following symptoms occurs: A corneal or scleral wound is visible. The aqueous humor is leaking (positive Seidel characters). The front chamber is very shallow (z. B. seems the cornea wrinkles to beat) or very low (by a rupture behind the lens). The pupil is irregular. If there is a suspicion of a Bulbusverletzung, measures are taken before an ophthalmologist is available in the application eye protection (corneal erosions and debris: treatment) exist and in a fight the infection with systemic antibiotics, such as for intraocular foreign body (intraocular foreign bodies) , Topical antibiotics are not applied. A vomiting which increases the intraocular pressure (IOP) and may cause leakage of ocular contents is prevented by anti-emetics, if necessary. As a fungal infection of open wounds is dangerous, corticosteroids are contraindicated until the wounds were surgically closed. A tetanus prophylaxis is indicated for open Bulbusverletzungen. Very rarely the uninjured contralateral eye becomes inflamed for any breach of the bulb with (sympathetic ophthalmia; Sympathetic ophthalmia), this untreated can lead to blindness. It is an autoimmune reaction that can be suppressed with Kortikosteroidtropfen and can be prescribed by a ophthalmologist. Hyphema (bleeding of the anterior chamber) The consequence of Hyphaemas may be recurrent bleeding, glaucoma and bloody discoloration of the cornea, all of which can result in permanent visual loss. In the foreground are the symptoms of associated injuries to the hyphema is so large that it interferes with vision. During the inspection itself Blutkoagele show in the anterior chamber. The bleeding presents itself as a meniscus-shaped blood levels in the related (usually lower) anterior chamber. The less severe form of Mikrohyphaemas is reflected in the direct inspection as clouding of the anterior chamber and in the slit-lamp examination. An ophthalmologist should be consulted as soon as possible. The patient keeps bed rest with increased to 30-45 ° head and gets eye protection to protect the eye from further trauma (corneal erosions and foreign bodies). Patients with a high risk of recurrent bleeding (eg. As in extensive Hyphaemas, coagulation disorders, anticoagulant medication, sickle cell anemia), high intraocular pressure (IOP), the or patients with suspected of non-compliance are admitted to hospital difficult to adjust. Oral or topical NSAIDs are contraindicated because they can reinforce a tendency to bleed. The IOP may increase acute (within hours, mostly in patients with sickle cell disease or trait carriers) or until months or years later. The IOP will therefore monitor a few days and then periodically over the following weeks and months and the onset of symptoms (eg. As eye pain, Visusabnahme, nausea, similar to the symptoms of acute narrow-angle glaucoma). With increasing pressure, is timolol 0.5% 2 times daily, brimonidine 0.2% or 0.15% 2 times a day, or both. The print is then examined usually 1 or 2 times daily. The response to the treatment is determined by the IOP is checked every 1 or 2 hours or until a significant pressure drop is established. Often mydriatic drops are prescribed for. B. scopolamine 0.25% 3 times daily or atropine 1% over 5 days) and topical corticosteroids (3 times a day for. Instance prednisolone acetate over 2-3 1% 4-8 times a day weeks. If the bleeding is recurrent, an ophthalmologist should be consulted. a dose of aminocaproic acid 50-100 mg / kg po every 4 hours (no more than 30 grams a day) for 5 days may reduce recurrent bleeding. Miotic or mydriatic drugs should also be administered. Rarely is in recurrent bleeding in connection with a secondary glaucoma surgery for blood removal necessary. blow-out fracture to a blow-out fracture occurs when a blunt trauma drives the orbital contents through one of the weakest points of the orbit, which is typically the orbital floor but. Mittelwand- and Orbitadachfrakturen can also vorko . Mmen The symptoms include diplopia, enophthalmos, a displaced inferiorly bulb, hypoesthesia of cheek and upper lip (by violation of the infra-orbital nerve) and subcutaneous emphysema. Also, nosebleeds, eyelid edema and ecchymosis may occur. The diagnosis is best provided using a CT with thin sections through the facial bones. In a continuing even after two weeks diplopia or a cosmetically unacceptable enophthalmos a surgical intervention is indicated. Patients should be advised not to blow your nose to prevent subcutaneous dissection of air. A topical vasoconstrictor about 2-3 days can relieve nasal bleeding. SUMMARY An ophthalmologist should be consulted when an eyelid injury is complex (eg., By the lid margin through, by the tarsal or canaliculus, which can have ptosis or leakage of orbital fat may result). Bulbusverletzungen can cause (haemorrhage, detachment or edema) Iris injury, cataract, lens dislocation, glaucoma, vitreous hemorrhage or damage to the retina. A globe rupture should be suspected when a trauma resulting in a visible corneal or Skleraverletzung when the chamber water leaks, an unusually shallow or deep anterior chamber is seen, or an irregular pupil. A hyphema, best diagnosed by slit-lamp examination, requires bed rest with the head raising at an angle of 30-45 °, and close monitoring of intraocular pressure. Patients must be treated surgically if they have blowout fractures, a persistent diplopia cause> 2 weeks or an unacceptable enophthalmos.

Health Life Media Team

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