University of Colorado School of Medicine, Aurora, CO, USA.
Am Fam Physician. 2020 Nov 1;102(9):539-545.
Central retinal artery occlusions, chemical injuries, mechanical globe injuries, and retinal detachments are eye emergencies that can result in permanent vision loss if not treated urgently. Family physicians should be able to recognize the signs and symptoms of each condition and be able to perform a basic eye examination. Patients with a central retinal artery occlusion require urgent referral for stroke evaluation and should receive therapy to lower intraocular pressure and vasodilating agents to minimize retinal ischemia. Chemical injuries require immediate irrigation of the eye to neutralize the pH of the ocular surface. A globe laceration or rupture is common in patients with a recent history of trauma from a blunt or penetrating object. Physicians should administer prophylactic oral antibiotics after a globe injury to prevent endophthalmitis. The eye should be covered with a metal shield until evaluation by an ophthalmologist. Patients with symptomatic floaters and flashing lights should be referred to an ophthalmologist for a dilated funduscopic examination to evaluate for a retinal tear or detachment.
视网膜中央动脉阻塞、化学伤、机械性眼球损伤和视网膜脱离是眼部急症,如果不及时治疗,可能导致永久性视力丧失。家庭医生应该能够识别每种疾病的体征和症状,并能够进行基本的眼部检查。视网膜中央动脉阻塞的患者需要紧急转介进行中风评估,并应接受降低眼内压和血管扩张剂的治疗,以最大限度地减少视网膜缺血。化学伤需要立即冲洗眼睛,以中和眼表的 pH 值。近期有钝器或穿透性物体外伤史的患者常发生眼球裂伤或破裂。医生应在眼球受伤后给予预防性口服抗生素,以预防眼内炎。在接受眼科医生评估之前,应使用金属眼罩覆盖眼睛。有症状的漂浮物和闪光的患者应转介给眼科医生进行散瞳眼底检查,以评估是否有视网膜裂孔或脱离。