How to deal with ophthalmic emergencies?

Acute attack of primary acute angle-closure glaucoma

Causes: The patient is tired, emotionally agitated, angry, or in a dark environment.

Symptoms: 1. Iridescence (colorful halos when viewing lights), a significant decrease in vision, or only light perception.

2. Severe eye pain, ipsilateral migraine, and even nausea, vomiting and other symptoms.

judge:

1. The patient or family member can press the eyeball alternately with their fingers and judge the intraocular pressure based on the hardness of the eyeball;
2. The patient's eyes can be observed with the help of a flashlight, and the patient's conjunctiva can be seen to be swollen and congested, and even the eyelids are swollen. The cornea is gray (because the cornea is edematous and foggy). The pupil is dilated, mostly in the shape of a vertical oval or tilted to one side, and the light reflex disappears.

It should be differentiated from other diseases to avoid misdiagnosis: Many patients think they have high blood pressure, gastrointestinal diseases, or getting angry, so they go to the emergency department and are treated as internal medicine diseases, which delays treatment.

Emergency treatment: Family members should comfort the patient and keep him calm; let the patient lie flat; seek emergency ophthalmic treatment.

Chemical and thermal burns of the eye

Cause: Accidental splashing of chemical liquids, gases and chemical dust into the eyes.

Potentially harmful objects:

Chemical liquids, such as strong acids (sulfuric acid, hydrochloric acid and other acids) and strong alkalis (sodium hydroxide, potassium hydroxide, ammonia water, alkali sulfide solution, etc.).

Chemical gases, such as hydrogen sulfide, ammonia, etc.

Chemical dust, such as fuel, fertilizer, lime, etc.

Symptoms: Eye irritation symptoms such as red eyes, eye pain, burning or foreign body sensation, tearing, eyelid spasm, difficulty opening the eyes, etc.

Judgment: Eye irritation symptoms after contact with chemical substances. Chemical residues, burnt skin, black scabs, etc. can be seen on the eyelids, eyelashes, and inside the eyes.

Emergency treatment: Once exposed to chemical substances, the eyes should be rinsed immediately on the spot. It is best to immerse the head in water, open the eyes, shake the head, and rinse thoroughly. The water source is preferably tap water. As long as the water quality is clear and the water volume is sufficient, any clean water can be used. The more thorough the rinse, the better. Generally, it takes 30 minutes to rinse. After rinsing, immediately transfer to an ophthalmologist for treatment.

Photoelectric ophthalmia

Causes: History of exposure to ultraviolet rays, such as electric welding (most common among welders), plateaus, snow and water reflections.

Incubation period: 3~8 hours.

Symptoms: Strong foreign body sensation, stinging, photophobia and blepharospasm.

Judgment: After the eyes are exposed to ultraviolet rays for 2 to 12 hours, the patient feels eye pain, fear of light, difficulty opening the eyes, eye pain as if many grains of sand have entered the eyes, blurred vision, eyelid skin congestion, and red eyes.

Emergency treatment: Patients need to go to the hospital to see an ophthalmologist in time and take precautions. Electric welders must wear protective masks or glasses when operating. In addition, ultraviolet rays reflected from sunlight on plateaus, snowy land or deserts can also cause photoelectric eye inflammation, so protective glasses are required.

Foreign matter in the eye

Causes: foreign objects such as mosquitoes, dust, shampoo, iron filings, etc. entering the eyes.

Symptoms: pain, tearing, foreign body sensation, inability to open eyes, etc.

Judgment: The patient is aware of a foreign body sensation in the eye, and can feel the foreign body rubbing against the eye when the eye is closed. People around the patient can see the foreign body and inform the patient.

Emergency treatment: Do not rub your eyes after foreign matter enters your eyes, because rubbing your eyes may scratch the cornea, or even embed the foreign matter deep into the cornea, aggravating the damage, causing vision loss or even blindness. First, gently pull up the upper eyelid skin forward. There is a gap between the upper eyelid and the eyeball, allowing tears to flow out to wash away the foreign matter. Sometimes the foreign matter can be washed out in a few seconds. If it doesn't work once, do it several times (avoid rubbing your eyes). Secondly, if the foreign matter cannot be washed out, ask your family or friends to turn over the eyelids, and use a cotton swab or a clean handkerchief dipped in cold boiled water to gently remove the foreign matter attached to the inner surface of the eyelid (avoid turning the eyeball in a panic to prevent the foreign matter from causing further damage to the eye). Finally, if you can't find the foreign matter, use a flashlight to shine it. If the foreign matter is embedded in the black eyeball, you should go to the ophthalmology department of the hospital immediately for treatment.