Internal Medicine

0521779407-C03 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:54

406 Corneal Ulcer Coronary Artery Injury

Routine

■Later treatment concerns visual rehabilitation, if necessary

complications and prognosis

Complications

■Corneal scarring:? vision, depending on density & location of scar

■Corneal thinning:? vision secondary to irregular astigmatism

■Corneal vascularization: later reduction in vision due to corneal lipid

deposits

■Corneal perforation: may require tissue adhesive, corneal patch

graft, or cornea TX

■Endophthalmitis: may occur due to intraocular extension of infec-

tion after perforation

Prognosis

■Impact on visual acuity depends on location & severity of any corneal

scarring, thinning, & vascularization

■Visual rehabilitation may require glasses, rigid contact lenses, laser

phototherapeutic keratectomy, or cornea TX

Coronary Artery Injury................................

JUDITH A. WISNESKI, MD

history & physical

■Myocardial ischemia

tests

■ECG – ST changes and new Q waves

■Blood – Elevation of Troponin I and other cardiac enzymes

■Coronary angiography (most important) detect the injury and pres-

ence of CAD

differential diagnosis

n/a

management

■Surgical intervention essential for laceration

■Thrombolytics and anticoagulation for acute thrombosis, pending

other injuries