Skip to Main Content

+

  • • Suspected corneal abrasion.

    • History of eye trauma, prolonged use of contact lenses, or irritability in a nonverbal patient.

    • Abnormal vision.

    • • Decreased visual acuity.

      • Diplopia.

    • Abnormal sensation.

    • • Eye pain.

      • Photophobia.

      • Foreign body sensation.

    • Abnormal appearance.

    • • Blepharospasm.

      • Tearing.

      • Conjunctival erythema.

      • Visible corneal defect.

      • Visible corneal foreign body.

++

Absolute

+

  • • Penetrating trauma with suspected globe rupture.

    • Chemical burn.

    • Retained contact lens.

    • Hypersensitivity to fluorescein.

    • Eye patching of an abrasion caused by a contact lens or a contaminated surface is contraindicated due to increased risk of infection.

++

Relative

+

  • • Suspected minor chemical burn.

+

  • • Examination gloves.

    • Sterile isotonic irrigation solution (0.9% saline or lactated Ringer’s). Copious tap water at room temperature is an acceptable alternative to prevent treatment delay.

    • Topical ophthalmic anesthetic solution (proparacaine 0.5% or tetracaine 0.5%).

    • Fluorescein dye (single-dose dropper or dye-impregnated ophthalmic paper strip).

    • Cobalt blue light (handheld direct ophthalmoscope or slit lamp) or ultraviolet light (Wood’s lamp).

    • Eye patch (occlusive or standard).

+

  • • Hypersensitivity reaction to fluorescein.

    • Permanent fluorescein staining of a contact lens.

    • Iatrogenic corneal abrasion if fluorescein strip touches the eye.

    • Eye patching may increase discomfort and risk of infection.

+

  • • A corneal abrasion is a simple scratch limited to the corneal epithelial surface.

    • A corneal or conjunctival foreign body is irritating, and rubbing may lead to further abrasions.

    • Suspect an embedded eyelid foreign body when no object can be visualized and symptoms are persistent.

    • Copious irrigation and mechanical removal of a persistent foreign body is necessary to prevent further abrasions.

    • If possible, do not apply a topical ophthalmic anesthetic until a foreign body is visualized or you are confident that none is present.

    • • Patients can help localize a foreign body but sensation will be eliminated by the topical anesthetic.

      • Patient’s inability to feel increases the potential for abrasions since there is no further pain or apprehension with blinking, eye movement, or rubbing.

+

  • • Apply topical ophthalmic anesthetic solution after foreign body has been visualized or ruled out to decrease pain and facilitate procedure and eye examination.

+

  • • Age-appropriate positioning and restraint as necessary to complete eye examination.

+

+

  • • The cornea is the transparent outermost layer that covers the iris and pupil of the eye. Cornea must remain transparent to refract light properly.

    • The corneal tissue is arranged in 5 layers:

    • • Epithelium: The outermost layer that contains sensory nerves and comprises about 10% of the cornea.

      • Bowman’s layer: The basement membrane for epithelial cells.

      • Stroma: Provides support and is primarily composed of water and collagen and comprises about 90% of the cornea.

      • Descemet’s membrane: Provides elasticity and is composed of collagen.

      ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.