Top 10 Eye Emergency Pearls

  1. Always screen patient for an Afferent Pupillary Defect (APD)!
  2. A negative Seidel Test does not rule out a Globe rupture
  3. Avoid NSAIDS and aspirin in Hyphemas and Globe Rupture
  4. CT Scan of the Orbit is only 56-68% sensitive for identifying a Globe Rupture, so don’t solely rely on it for the diagnosis!
  5. Order a Sickle Cell Protein Hemoglobin Electrophoresis test for every patient that is African American and presents with a traumatic hyphema.
  6. Avoid Topical Pain control, such as Tetracaine 0.5%, in Hyphemas
  7. Avoid Carbonic Anhydrase Inhibitors such as Acetazolamide in Sickle Cell patients with hyphema
  8. Retrobulbar Hematoma is a clinical Diagnosis: If IOP > 40mmHg, proptosis and APD, then immediately treat! Do not wait for CT scan!
  9. In, Acute Angle Closure Glaucoma, pupil must be mid-dilated!
  10. If no APD, then it cannot be Central Retinal Artery Occlusion!

Post by: Yenis Paez-Perez, DO

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