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Clinical Examination of Eye Injuries

Examination Map HISTORY

Past Medical History

Prior vision assessment

Mental health status

History of the Present Condition

General health status

Location of pain

Radicular symptoms

Mechanism of injury

Onset of condition

INSPECTION

Periorbital Area

Discoloration

Gross deformity

Inspection of the Globe

General appearance

  • Eyelids

  • Cornea

  • Conjunctiva

  • Sclera

  • Iris

  • Pupil shape and size

Palpation

Orbital Margin

Frontal Bone

Nasal Bone

Zygomatic Bone

Soft Tissue

FUNCTIONAL ASSESSMENT

Vision Assessment

Pupillary Reaction to Light

NEUROLOGICAL EXAMINATION

CN III, IV, VI

REGION-SPECIFIC PATHOLOGIES AND SELECTIVE TISSUE TESTS

Orbital Fractures

Blowout fractures

Corneal Abrasion

Corneal Laceration

Traumatic Iritis

Hyphema

Retinal Detachment

Ruptured Globe

Conjunctivitis

Foreign Body Embedment

History

Table 15-1Blunt Eye Trauma and the Resulting Eye Pathology*

Inspection

Table 15-2Findings That Warrant Immediate Referral to an Ophthalmologist
FIGURE 15-1

Inspection of the upper surface of the eye. The upper eyelid is inverted around a cottontipped applicator to expose the upper portion of the sclera and conjunctiva.

FIGURE 15-2

Laceration of the eyelid. This injury may also conceal underlying eye trauma.

FIGURE 15-3

Hyphema, a collection of blood within the anterior chamber of the eye.

FIGURE 15-4

Subconjunctival hemorrhage. This condition by itself is usually benign but may accompany underlying pathology.

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