Regions Trauma Wiki

A basic eye evaluation must be performed prior to calling a consult. This consists of:
1. external assessment of the lids, canalicular area and conjunctiva
2. in the awake patient, a basic visual acuity exam (light vs dark, gross acuity by finger counting)
3. basic internal assessment, including pupil size and shape, and gross appearance of the anterior chamber

Once the exam is complete, refer to this table for proper management.

Ocular PathologyCall Optho NowCall During Business HoursNo Need To Call
Lid - lacerationNoCover with moist gauzeNo
Lid - laceration near canaliculusYesNoNo
Conjunctiva - hemorrhageNoNoYes, if not associated with trauma
Conjunctiva - lacerationYesNoNo
Conjunctiva - foreign bodyIf not removableIf removableNo
Cornea - chemical injuryFlush copiouslyNoNo
Cornea - abrasionNoBegin topical ATBNo
Cornea - lacerationYesNoNo
Cornea - foreign bodyYesNoNo
HyphemaBed rest, HOB at 30ºNoNo
Iris or lens injuryYesNoNo
Globe ruptureYesNoNo
Optic nerve injury/swellingYesNoNo
Fractures (at recommendation of Plastics/ENT)NoYes, or f/u in clinicNo
Visual acuity changeYesNoNo

All consultations will be made at the direction of the Trauma Attending. If the Ophthalmology resident does not respond appropriately, the Ophthalmology Attending will be called. If a consultation is felt to be inappropriate by the Ophthalmology Attending, the Trauma Attending or Trauma Director should be called directly to discuss it.