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HEAD, EYE, EAR, NOSE, AND THROAT

EMERGENCIES

TREATMENT

■ Removal of foreign bodies and associated rust rings may be achieved with
a needle, fine forceps, spud, or ophthalmic burr under magnified direct
visualization using a slit lamp.
■ Topical NSAIDs may be helpful. Do not send the patient home with
topical anesthetics(eg, tetracaine, proparacaine) because they can predis-
pose the patient to further corneal injury.
■ Topical antibiotics
■ Patching further impairs vision and may increase pain and incidence of
infection; don’t patch corneal abrasions.
■ Cycloplegics are of limited benefit.
■ Ophthalmology follow-up

Corneal Ulcer

A true ocular emergency; most commonly occurs following extended contact
lens use

ETIOLOGY

Pseudomonas, Staphylococcus, andStreptococcus

A

B

FIGURE 14.32. Chemosis seen in patient with allergic conjunctivitis.

(Courtesy of Timothy D. McGuirk, DO as reproduced, with permission, from Knoop KJ, Stack
LB, Storrow AB. Atlas of Emergency Medicine, 2nd ed. New York: McGraw-Hill, 2002:36.)