Assistant Lecturer of Ophthalmology Benha University Hospitals

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Presentation transcript:

Assistant Lecturer of Ophthalmology Benha University Hospitals Ophthalmology Cases In office and ER By Nader Hussein Assistant Lecturer of Ophthalmology Benha University Hospitals

Objectives Awareness about DDx of same complaints Deliver adequate correct first aid in ER Avoid misdiagnosis / Overlooking / neglecting signs Importance of referral + higher ophthalmic consultation

Be careful Dx Act Refer

Be careful Steriods Ignorance Glaucoma

ALWAYS REVISE TREATMENT

Patient knows nothing about ophthalmology Even minor complaints may lead to sight threatening effects

Dreams, plz :D

Corneal ulcer HZO

Stye / Chalazion Check VA

SC Hge Occult Globe Rupture ? CBC - Bleeding

Abrasions

FB

Chemical Trauma Wash Extract FB History Antibiotics Follow up

Conjunctivitis Hygine Cornea ? Contact lens ?

Questions and Answers

Baby with watery eye Baby with discharge Baby with large eye Baby with hazy cornea

Baby e large globe ?

Cloudy Cornea in baby?

Preseptal / Orbital Cellulitis

Rhino-orbital mucormycosis

charonboat

Hyphema Trauma Bleeding Rubeosis ! Problems ? IOP Staing Rebleeding

Globe Rupture CT NPO Tetanus - Antiemetics Shield - Refer

Orbital fractures

CARE OF COMATOSED ?

Sight – saving team ICU care of comatosed eye Pediatric PICU – NICU weekly checkup Don’t prescribe empirical treatment in outpatient

References Globe Rupture, J Robson, Feb 16 2007, www.emedicine.com Handbook of ocular disease, 2000 - 2001 Jobson Publishing, www.revoptom.com/handbook/hbhome.htm P T Khaw et al, Clinical review “ABC of Eyes- Injury to the eye” BMJ 2004;328:36-38 (3 January) Cameron et al, Textbook of Adult Emergency Medicine, Second Ed, Churchill Livingston, 2004 Eye Emergency Manual, NSW Ophthalmology Service, 2007 Retinal Detachment, G Larkin , Apr 7, 2008 www.emedicine.com Acanthamoeba, N Crum-Cianflone, Jun 30 2008, www.emedicine.com Facial Trauma, Orbital Floor Fractures (Blowout), A Cohen, Dec 18 2006, www.emedicine.com Glaucoma, Acute Angle-Closure, A Darkeh, Oct 3 2007, www.emedicine.com Scleritis, T Gaeta, Apr 14 2008 www.emedicine.com Wilkins RB, Havins WE. Current treatment of blow-out fractures. Ophthalmology. May 1982;89(5):464-6

Thank You