retinal detachment

KEY POINTS:

--can be traumatic or non-traumatic

--often present with 'floaters' in one eye, peripheral visual field defect

--can lead to loss of vision

--need optho consultation, dilated eye exam, may need retinopexy (something I can't do in the ED)


OCULAR ULTRASOUND:
--high-frequency linear (7.5-10 MHz) transducer
--retinal detachment: a prominent, continuous linear density rising from the fundus


Reference(s): uptodate.com: retinal tear and detachment, ACEP Focus on ocular ultrasound for retinal detachment (picture also)

photokeratitis

WHAT IS IT?

--UV (ultraviolet) keratitis
--UV light damages corneal epithelium
--often presents some time after exposure (latent period 6-12 hours)
--generally self-limited with complete resolution in 1-3 days


COMMON PRESENTATIONS:
--welders
--snowblindness

--bilateral eye pain, injection, photophobia, foreign body sensation
--can have associated facial erythema/edema


MANAGEMENT:
--analgesics (photokeratitis hurts)
--antibiotic ointments (prophylaxis and lubrication)
--optho follow-up
--advise proper protective eyewear


10-SECOND RECAP:
--photokeratitis=corneal epithelial damage from UV light
--often from welding, snowblindness
--bilateral pain, photophobia, injection; often presents after a 6-12 hr latent period
--treatment toolbox: pain meds, antibiotic oinments, optho follow-up, better goggles

Reference(s): uptodate.com: photokeratitis, photo