小结
定义
病史和体格检查
关键诊断因素
- hyphaema
- ecchymosis
- severe eye pain
- blurred vision
- corneal abrasions
- corneal oedema
- sub-conjunctival haemorrhages
- corneal and conjunctival lacerations
- punctate epithelial erosions
- loss of sight
其他诊断因素
- excessive lacrimation
- conjunctival chemosis
- conjunctival hyperaemia
- corneal epithelial defect/abrasion
- open globe injury
- eyelid burns
- photophobia
- diplopia
- miosis
- corneal stromal clouding
- iridodialysis
- conjunctival foreign body
- corneal foreign body
- Descemet's membrane tears
- corneoscleral lacerations
- persistent headache
- loss of consciousness
- blood or clear fluid from ears or nose
- inability to move eye(s)
危险因素
- age 18-45 years
- male sex
- no protective eyewear
- workplace injuries
- falls
- fireworks
- exposure to ultraviolet light
- previous eye surgery
- alcohol-based hand sanitisers
诊断性检查
首要检查
- CT scan of orbit
- CT scan of head
- MRI scan of head
需考虑的检查
- plain x-ray
- B-scan ultrasonography
- ultrasound biomicroscopy
- optical coherence tomography
- fluorescein angiography
- fundus autofluorescence
- urine drug screen
- sickle cell trait screen
治疗流程
superficial injuries without a foreign body
hyphaema
corneal abrasion
open globe injury
recurrent corneal erosions or poor healing
撰稿人
作者
Fasika Woreta, MD, MPH
Associate Professor of Ophthalmology
Residency Program Director
Director, Eye Trauma Center
Wilmer Eye Institute
Johns Hopkins University School of Medicine
Baltimore
MD
利益声明
FW declares that she has no competing interests.
鸣谢
Dr Fasika Woreta wishes to gratefully acknowledge Dr Ron Adelman and Dr Elena Raluca Raducu, previous contributors to this topic.
利益声明
ERR declares that she has no competing interests.
同行评议者
Yewlin E. Chee, MD
Assistant Professor of Ophthalmology
University of Washington
Seattle
WA
利益声明
YE declares that she has no competing interests.
Andrew W. Eller, MD
Professor of Ophthalmology
University of Pittsburgh School of Medicine
Pittsburgh
PA
利益声明
AE declares that he has no competing interests.
Saloni Kapoor, MD
Clinical Assistant Professor of Medicine
UPMC Mercy Hospital
Pittsburgh
PA
利益声明
SK declares that she has no competing interests.
Seanna Grob, MD, MAS
Assistant Professor of Ophthalmology
Oculoplastic Surgeon
University of California San Francisco
San Francisco
CA
利益声明
SG has written a book on ocular trauma.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Kuhn F, Mester V, Berta A, et al. Epidemiology of severe eye injuries: the United States Eye Injury Registry (USEIR) and the Hungarian Eye Injury Registry (HEIR) [in German]. Ophthalmologe. 1998 May;95(5):332-43. 摘要
Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am. 2002 Jun;15(2):139-43. 摘要
MacEwen CJ. Ocular injuries. J R Coll Surg Edinb. 1999 Oct;44(5):317-23. 摘要
American Academy of Ophthalmology. Policy statement: referral of persons with possible eye diseases or injury. Apr 2014 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
指南
- Pediatric eye evaluations preferred practice pattern
- RCH clinical practice guidelines: acute eye injury
更多 指南登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明