TMOD Exam Study Guide (FINAL EDITION) Questions with Correct Answers

TMOD Exam Study Guide (FINAL EDITION) Questions with Correct Answers Chemical Burn Treatment and Follow Up? *Irrigation with Saline* Wait 5 to 10 minutes and then check pH Re-irrigate until pH = *7-7.4* Could use proparicaine prior to irrigation Could use Cyclo or NSAID for pain Could use topical Erythromyacin 1-2qh *Avoid Phenylepherine* due to blanching Follow up *Daily* until Epithelium healed Corneal Abrasion Treatment and Follow Up? 1. *Antibiotic* - Fluoroquinolone QID for 5-7 days OR Erythromyacin/Bacitracin Ointment 2-4qh 2. DON'T PATCH 3. Could use a bandage CL 4. AVOID STEROIDS *Follow up 1 day* Then 3-5 days until healed Conj or Corneal Foreign Bodies Treatment and Follow Up? 1. Apply Proparicaine and remove FB 2. If Rust ring then remove with Alger 3. Then Treat same as Abrasion - DO NOT use Erythromyacin for FB (too weak) 4. Consider OCT/B-Scan to exclude intraocular FB 5. Remove Conj FB's with cotton swab soaked in 2.5% Phenly to reduce bleeding 6. PFAT may be given as needed 7. AVOID STEROIDS Follow up same as Abrasion Traumatic Iritis Treatment and Follow-Up 1. Cyclopentolate 2% TID 2. Prednisolone Acetate 0.125% QID *Follow Up 5-7 days* Perform Gonio 1 month after trauma to check for angle recession When healed discontinue Cyclo and *TAPER steroid*. Hyphema Treatment and Follow-Up 1. Check Blood Thinners/Sickle Cell 2. Avoid Gonio/measure IOP with Tono 3. *Rx Bed rest and keep head elevated* 4. *Shield over affected eye* 5. *Atropine 1.0% BID to TID* 6. *AVOID Aspirin/NSAID's/Prostaglandins* 8. Acetaminophen is okay 9. Increased IOP - start with Timolol, then Alpha Agonist Consider Hospitalization *Follow-up Next Day*Iridodialysis Treatment and Follow-Up Iridodialysis is the disinsertion of iris from the Sclerel Spur and Cyclodialysis is the disinsertion of the CB from the SP. Treatment includes *sunglasses, CL with artificial pupil or surgical correction*. Risk of glaucoma, treat same as POAG. If Hypotony use Atopine BID and Steroids Eyelid Laceration Treatment and Follow-Up? 1. Tetanus Prophylaxis 2. Systemic Antibiotics if FB 3. Clean wound - refer out Orbital Blow Out Fracture Treatment and Follow-Up? 1. *Forced ductions* to rule out nerve palsy one week after trauma 2. *CT scan of Orbit WITHOUT contrast* 3. *Broad Spectrum Oral Antibiotics*: Follow up at 1 week and 2 weeks after trauma Traumatic Retrobulbar Hemorrhage Main Treatment? Refer out - Aggressive Decompression Traumatic Optic Neuropathy Treatment? SIGNS: New APD/Decreased color *Pallor will appear weeks after trauma* Treatment depends on Etiology- Refer out Intraorbital Foreign Body Treatment? 1. Never remove an intraorbital FB until first obtaining imaging 2. Refer for surgery Ruptured Globe and Penetrating Ocular Injury Treatment? *(+)Seidel* Protect eye with Shield Systemic Antibiotics within 6h of injury Tetanus Prophylaxis Antiemetic for nausea *Refer for surgical repair* Intraocular Foreign Body Treatment? Protective Shield Tetanus Prophylaxis Vancomyacin 1g I.V. *Refer for Surgical Repair* Commotio Retinae/Berlin's edema Follow-Up and Treatment? SIGNS: Confluent retinal whitening with recent trauma. *No Treatment* usually clears w/o therapy Follow up in *1-2 weeks* (prn if RD symptoms)Traumatic Choroidal Rupture Treatment? Refer out for Anti-VEGF treatment Presentation and Etiology of Purtscher Retinopathy? Treatment and Follow-up? Vision loss with multiple CWS's and hemes. Etiology usually from injury to the head or *chest*. No treatment available. Repeat DFE 2-4 weeks. VA returns to baseline in 50%