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Ophthalmic Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Corneal abrasions are very painful but heal quickly. The pupil may be dilated in order to ease symptoms caused by ciliary muscle spasm; antibiotic drops or ointment should be prescribed four times a day. Topical anaesthetic drops should not be given for use at home since they inhibit corneal epithelial cell division and healing.
Management of Ophthalmic Injuries by the Forward Surgical Team
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Richard J. Blanch, Johno Breeze, William G. Gensheimer
A corneal abrasion within one year of any type of refractive surgery may cause corneal scarring, and therefore, early ophthalmology consultation should be sought if there is a concern about eye injury in a patient with a history of refractive surgery.
The Head and Neck
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
During elective surgery, tracheostomy is to be performed for any resection behind the premolar level to avoid airway obstruction secondary to laryngeal edema. The eyes should be covered to avoid corneal abrasions or lacerations. Blood transfusion must be available as fair amount of hemorrhage and blood loss is to be expected especially during maxillectomy and oral cavity resections. Chylous leak must be controlled by ligature rather than suture ligature that may enhance the leak. Certain nerves are preserved during neck dissection as mentioned before. Air embolism should be prevented. However, if it happens, finger pressure at the (suction) site is the first thing to apply. The patient’s head should be brought down, and the patient is placed in the left lateral Trendelenburg position. The nitrous oxide and oxygen are discontinued, and lidocaine drip is utilized for ventricular arrhythmias.
Efficacy of tarsoconjunctivomullerectomy in adults with acquired aponeurogenic blepharoptosis: a large single-surgeon case-series
Published in Orbit, 2023
Hrvoje Kovacic, René J Wubbels, Dion Paridaens
Complications during as well as after surgery occurred in 53 patients. Bleeding directly after surgery that necessitated adjuvant cauterisation occurred in one patient and in one patient a direct postoperative hematoma was noted. Postoperative bleeding or hematoma for which the patient visited the hospital occurred in 19 patients (in 8 within 24 h). Corneal abrasion occurred in 11 patients, for whom antibiotic ointment was prescribed. One patient with pre-existent history of recurrent keratopathy developed massive corneal erosions. This patient responded well to a course of topical antibiotics and had a favorable outcome. Conjunctivitis requiring topical antibiotics was observed in two patients, whereas two patients with eyelid infection were treated with oral antibiotics. Other reported complications were (temporary) complaints of dry eye in eight patients, postoperative pain mostly during the first week in five patients and complaints of itching in one patient. One patient had an allergic reaction to tobramycin ointment.
Maxillofacial trauma and ocular injuries: reports from a prospective study from Pondicherry, India
Published in Orbit, 2022
Shravya Choudhary Balla, Kirti Nath Jha, Sathyanarayanan Ramanujam, Krishnagopal Srikanth, Adithyapuram Ramachandran Rajalakshmi
High incidence of periorbital edema is a common clinical finding across all studies.1,9 Periorbital edema was seen in 75.5% of our cases. Mohanavalli et al. reported periorbital edema/ ecchymosis in the majority (79%); periorbital edema was the most common finding in midfacial fractures. We noted nine (8.1%) cases of orbital emphysema – four in relation to zygomaticomaxillary complex fracture, four in relation to nasal bone fracture and one in relation to blow out fracture. Mittal et al. reported orbital emphysema in 2.1% cases of midfacial fractures.1 Subconjunctival haemorrhage is another common finding.1,9 We observed corneal abrasion more frequently (5.9%) than others.1 About 2.2% patients in our study had hyphema which was similar to other studies.1,11
Effects of topical Coenzyme Q10, Xanthan Gum and Sodium Hyaluronate on corneal epithelial wound healing
Published in Clinical and Experimental Optometry, 2022
Leyla Asena, Gülşah Gökgöz, Fatma Helvacıoğlu, Gonca Özgün, Emine Ebru Deniz, Dilek Dursun Altinors
Although corneal abrasions are mostly benign and self-healing, the complications such as infectious keratitis or recurrent erosion syndrome may be severe. Rapid regeneration resulting in a healthy and well-organised epithelial layer is desired to increase patient comfort and decrease the rate of complications including development of infectious keratitis, persistent epithelial defects and prolonged ocular surface inflammation.17 Up to date, there are no standardised practices for the treatment and follow-up of patients with corneal abrasions. A wide range of substances or their combinations have been investigated. However, it is challenging to choose a single effective and commercially available therapeutic agent to support the healing process. Coenzyme Q10, Xanthan gum and sodium hyaluronate are therapeutic agents which are commercially available and variably adopted in clinical practice. Therefore, we aimed to compare the effect of three different commercially available non-preserved topical agents; a CoQ10 containing compound (coenzyme Q10 100 mg, vitamin E-TPGS 500 mg and Hypromellose 200 mg) (Visudrop; Liba Laboratories, Inc.), an eye gel containing 0.15% sodium hyaluronate, 1% xanthan gum and 0.3% netilmicin (Xanternet; SIFI SpA, Catania, Italy) and only 0.15% sodium hyaluronate (Eyestil; SIFI SpA, Catania, Italy) on corneal epithelial wound healing. We used a corneal epithelial defect-induced mouse model for this purpose.18