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Research ArticleClinical Guidelines & Primary Care

Management of Eye Trauma for the Primary Care Physician

Jonathan Y. Rho, Stephen C. Dryden, Brian M. Jerkins and Brian T. Fowler
The Journal of the American Board of Family Medicine September 2021, 34 (5) 1018-1029; DOI: https://doi.org/10.3122/jabfm.2021.05.210121
Jonathan Y. Rho
From the Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN (RYO, SCD, BMJ, BTF).
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Stephen C. Dryden
From the Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN (RYO, SCD, BMJ, BTF).
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Brian M. Jerkins
From the Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN (RYO, SCD, BMJ, BTF).
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Brian T. Fowler
From the Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN (RYO, SCD, BMJ, BTF).
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Article Figures & Data

Figures

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    Figure 1.

    Flowchart showing the approach to eye trauma for the triaging provider.

  • Figure 2.
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    Figure 2.

    Alkali burn. External photograph of an eye with alkali burn with chemosis (*), subconjunctival hemorrhage (^), epithelial defect with fluorescein staining (#), limbal stem cell damage (&), and pseudohypopion ($).

  • Figure 3.
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    Figure 3.

    Left inferior rectus entrapment. External photography composite of the primary positions of gaze of a patient with left inferior rectus entrapment and lower eyelid ecchymosis demonstrating vertical movement deficits in the left eye. Note, in primary position, the fixating right eye is higher relative to the hypotropic left eye, as appreciated by the uneven corneal light reflex (Hirshberg test).

  • Figure 4.
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    Figure 4.

    Orbital fracture with emphysema. Coronal CT scan of the orbit demonstrating right orbital floor (*) and medial wall fracture (^) with orbital emphysema (#).

  • Figure 5.
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    Figure 5.

    Orbital compartment syndrome. External photograph of the right eye with orbital compartment syndrome with signs of periorbital edema (*), hemorrhagic chemosis (^), and proptosis.

  • Figure 6.
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    Figure 6.

    Corneal laceration. External photograph of the left eye with a full-thickness corneal laceration with uveal prolapse (*).

  • Figure 7.
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    Figure 7.

    8-ball hyphema. External photograph of the right eye with deoxygenated blood filling the anterior chamber, also known as an 8-ball hyphema.

  • Figure 8.
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    Figure 8.

    Grade I Hyphema. External photograph of the left eye with blood covering less than 1/3 of the anterior chamber thus classified as a grade I hyphema (*). Note the color of the blood compared with the deoxygenated blood in Figure 6.

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    Figure 9.

    Retinal detachment with retinal tear. Wide-field fundus photograph of the right eye demonstrating a superotemporal horseshoe retinal tear (*) with retinal detachment extending into the macula. Note the demarcation line and elevated retinal vessels of the superotemporal arcade compared with the other retinal vasculature.

  • Figure 10.
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    Figure 10.

    Marginal eyelid laceration. External photograph of the right eye showing a full-thickness marginal lid laceration with orbital fat prolapse (*) and involvement of the canalicular system. Note the exposed tarsal plate (^) on the temporal portion of the laceration at the eyelid margin.

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The Journal of the American Board of Family   Medicine: 34 (5)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 5
September/October 2021
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Management of Eye Trauma for the Primary Care Physician
Jonathan Y. Rho, Stephen C. Dryden, Brian M. Jerkins, Brian T. Fowler
The Journal of the American Board of Family Medicine Sep 2021, 34 (5) 1018-1029; DOI: 10.3122/jabfm.2021.05.210121

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Management of Eye Trauma for the Primary Care Physician
Jonathan Y. Rho, Stephen C. Dryden, Brian M. Jerkins, Brian T. Fowler
The Journal of the American Board of Family Medicine Sep 2021, 34 (5) 1018-1029; DOI: 10.3122/jabfm.2021.05.210121
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Keywords

  • Chemical Burns
  • Eye Injuries
  • Hyphema
  • Lacerations
  • Ophthalmology
  • Optic Nerve Injuries
  • Orbital Fractures
  • Retinal Detachment
  • Soft Tissue Injuries
  • Telemedicine
  • Triage

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