- Corneal Foreign Body Removal
- Globe Luxation Reduction
- Lateral Canthotomy
- Tonometry
Corneal Foreign Body Removal
- Background
- Common corneal foreign bodies include metal, glass, plastic, wood, and sand. Must be removed in a timely manner to prevent infection and ocular necrosis
- Indications
- Foreign body in the cornea
- Contraindications
- Intraocular foreign body, hyphema, corneal laceration, multiple foreign bodies
- Complications
- Incomplete removal, conjunctivitis, epithelial injury, corneal perforation.
*Deep Dive: Corneal Abrasions and Foreign Bodies (Merck Manual)
Globe Luxation Reduction
- Background
- Occurs when the eyelids slip behind the midcoronal plane of the eye in a proptosed eyeball. Orbicularis oculi spasm maintains luxation. Early reduction is required to minimize visual impairment
- Indications
- Spontaneous or traumatic globe luxation
- Contraindications
- No absolute contraindications. Globe rupture is a relative contraindication.
- Complications
- Failure to reduce, retained lashes.
*Deep Dive: How to Reduce a Globe Sublux in the Emergency Department (EP Monthly)
Lateral Canthotomy
- Background
- Lateral canthotomy is the surgical exposure of the lateral canthal tendon, +/- incision of the inferior branch of the tendon (cantholysis), to relieve intraorbital pressure.
- Indications
- Orbital compartment syndrome (w/ acute loss of vision acuity, proptosis, or IOP > 40)
- Contraindications
- Suspected globe rupture
- Complications
- Globe injury, lacrimal gland/artery injury, incomplete cantholysis, bleeding, infection
*Deep Dive: Lateral Canthotomy and Cantholysis (emDocs)
Tonometry
- Background
- Diagnostic test that measures intraocular pressure.. Early detection of abnormal intraocular pressure can prevent irreversible vision loss
- Indications
- Suspected glaucoma, ocular trauma w/o globe rupture, before/after ophthalmic surgical procedures.
- Contraindications
- Infection, unhealed corneal abrasions/ulcers, ruptured globe
- Complications
- Infection, corneal abrasion, aggravation of ruptured globe.
*Deep Dive: Acute Angle Closure: Mastering Tonometry (The Procedural Pause)
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