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Module 14--Current Emergency--Corneal Abrasion:
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Essentials of Diagnosis:
--Pain, photophobia, and blurry vision.
--Uptake of fluorescein stain is key to diagnosis
--Always rule out globe perforation
Clinical Findings:
--Pt c/o pain, photophobia, and blurry vision.
--Pt's with severe pain and blepharospasm may require proparacaine, 0.5%, instilled in the eye to facilitate eye examination
--In severe cases, the eye is red and the corneal surface is irregular and loses its normal luster. Staining with fluorescein reveals a defect in the corneal epithelium.
--Rule out infection or globe perforation as needed.
Treatment:
--Irrigate the eye gently with sterile saline solution if needed to remove debris and loose foreign bodies.
--In severe cases, instill tropicamide to relax the ciliary muscle and relieve pain. Instill ophthalmic antibiotic ointment.
--Consider nonsteroidal anti-inflammatory ophthalmic drops for pain control.
--Provide systemic analgesia as needed.
--Never give the patient topical anesthetics, which may lead to irreversible corneal damage.
**
Caution: Do not use ointment containing corticosteroids
**
Disposition:
--Refer patients for daily outpatient follow-up care.
--Ophthalmologic consultation should be obtained for corneal abrasions that fail to resolve in 48-72 hours
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