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    Occular Emergencies

    Uploaded by

    Alina Pun
    Medical surgical nursing. Occular emergencies

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    © All Rights Reserved
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    Occular Emergencies

    Uploaded by

    Alina Pun
    11 views2 pages
    Medical surgical nursing. Occular emergencies

    Original Title

    occular Emergencies

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    © © All Rights Reserved

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    Medical surgical nursing. Occular emergencies

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    11 views2 pages

    Occular Emergencies

    Uploaded by

    Alina Pun
    Medical surgical nursing. Occular emergencies

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Ocular Emergencies

    Table 2
    Diagnosis and Initial Outpatient Treatment of Ocular Emergencies

    SLIT-LAMP EXAMINATION
    DISORDER SIGNS AND SYMPTOMS INITIAL TREATMENT
    FINDINGS

    Mechanical Normal or damaged Decreased anterior chamber Eye shield


    injury to the cornea; moderate to depth relative to uninjured
    globe severe pain; normal or eye; irregular or deviated Tonometry contraindicated
    decreased vision; pupil toward the direction of
    hyphema; red injury; positive Seidel test Leave embedded foreign object
    eye/subconjunctival in place
    hemorrhage in the area
    360 degrees around the Scheduled analgesia and
    cornea antiemetics; update tetanus
    immunization

    Immediate referral to an
    ophthalmologist

    Chemical Cornea may have minor Findings depend on the Eye irrigation with normal saline
    injury epithelial damage or be severity; corneal and scleral or lactated Ringer's solution until
    opaque; moderate to melting may occur if injury is pH is normal
    severe pain; blurred severe
    vision; reflex
    blepharospasm; Continue eye wash on way to the
    photophobia; sensation emergency department or an
    of a foreign body; red ophthalmologist
    eye/conjunctiva

    Central Clear cornea; amaurosis Interrupted columns of blood Lowering IOP with mannitol
    retinal fugax (transient, within the retinal vessels (Osmitrol) 0.25 to 2.0 g per kg IV
    artery painless unilateral (sometimes referred to as once, acetazolamide (Diamox*)
    occlusion vision loss) or “boxcarring”) and attenuation 500 mg IV or orally once,
    permanent vision loss; of retinal arteries; cherry-red carbogen inhalation,
    red eye/conjunctiva spot at the fovea; pale administering oral nitrates, or by
    fundus; pupil may be dilated laying the patient on his or her
    and react poorly to light back

    Ocular-digital massage
    SLIT-LAMP EXAMINATION
    DISORDER SIGNS AND SYMPTOMS INITIAL TREATMENT
    FINDINGS

    Immediate referral to an
    ophthalmologist

    Acute Acute onset of severe Mid-dilated and sluggish Lowering IOP with acetazolamide
    angle- pain; blurred vision; pupil; normal or hazy cornea; 500 mg orally once; and one drop
    closure frontal headache; halos shallow anterior chamber each of 0.5% timolol maleate
    glaucoma around lights; increased (Timoptic), 1% apraclonidine
    IOP; red eye/conjunctiva (Iopidine), and 2% pilocarpine
    (Isopto Carpine) one minute
    apart and repeated three times at
    five-minute intervals

    Immediate referral to an
    ophthalmologist

    Retinal Normal to peripheral or Normal conjunctiva and Antitussives or antiemetics (if


    detachment central vision loss; cornea; normal pupil; pale, needed)
    absence of pain; detached retina
    increasing floaters;
    Referral to an ophthalmologist
    unilateral photopsia;
    within 24 hours
    metamorphopsia

    IOP = intraocular pressure; IV = intravenously.

    *—Brand only available in the oral formulation.

    Copyright © 2007 by the American Academy of Family Physicians.


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