Janda A M
Hennepin County Medical Center, Department of Ophthalmology, Minneapolis, MN 55415.
Postgrad Med. 1991 Nov 15;90(7):51-2, 55-60. doi: 10.1080/00325481.1991.11701122.
Many types of ocular trauma can be diagnosed and treated in the primary care office, particularly if a slit lamp is available. Treatment for corneal abrasions consists of applying a cycloplegic medication, antibiotic ointment, and a patch (unless a corneal ulcer is suspected). Iritis can be treated with cycloplegics and topical corticosteroids; the prescribing physician should be familiar with the potential ocular side effects and complications. Hyphemas are treated with bed rest, topical atropine sulfate drops and topical corticosteroids, as well as measures to prevent rebleeding. A slit lamp, topical anesthesia, and a foreign-body spud greatly facilitate the removal of foreign bodies from the cornea. Acid and alkali burns should be irrigated until the pH is normal and then should be treated like a corneal abrasion. Lid lacerations must be repaired with care to preserve proper functioning of the lid. Ruptures of the globe are serious injuries requiring surgical repair and long-term follow-up.
许多类型的眼外伤可在初级保健诊所进行诊断和治疗,特别是如果有裂隙灯的话。角膜擦伤的治疗包括应用睫状肌麻痹剂、抗生素眼膏和眼罩(除非怀疑有角膜溃疡)。虹膜炎可用睫状肌麻痹剂和局部皮质类固醇治疗;开处方的医生应熟悉潜在的眼部副作用和并发症。前房积血的治疗包括卧床休息、局部应用硫酸阿托品滴眼液和局部皮质类固醇,以及预防再次出血的措施。裂隙灯、表面麻醉和异物针极大地有助于从角膜移除异物。酸碱烧伤应冲洗至pH值正常,然后按角膜擦伤进行治疗。眼睑裂伤必须小心修复以保持眼睑的正常功能。眼球破裂是严重损伤,需要手术修复和长期随访。