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This retrospective study showed that EM providers are equipped to perform lateral canthotomy and cantholysis (C&C) in cases of orbital compartment syndrome (OCS) with success rates comparable to ophthalmologists.
Source
Success rates of lateral canthotomy and cantholysis for treatment of orbital compartment syndrome. Am J Emerg Med. 2023 Jun 1;70:140-143. doi: 10.1016/j.ajem.2023.05.037. Epub ahead of print.
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Orbital cellulitis is a high-risk and low-prevalence disease characterized by a painful, red eye, usually with eyelid erythema. Red flags include pain with eye movements, photophobia, diplopia, decreased visual acuity, decreased color vision, and proptosis.
Source
High risk and low prevalence diseases: Orbital cellulitis. Am J Emerg Med. 2023 Jun;68:1-9. doi: 10.1016/j.ajem.2023.02.024. Epub 2023 Feb 26.
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A smartphone app was developed to provide cobalt blue lighting in selfie mode to diagnose corneal injuries. See images below!
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Using Tegaderm™ during ocular ultrasound was associated with poorer image quality and had no effect on patient comfort. If you’re using ocular ultrasound as a modality, consider if using a Tegaderm™ will get in the way of a good diagnosis.
Source
Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound. Am J Emerg Med. 2022 Aug 28;61:87-89. doi: 10.1016/j.ajem.2022.08.044. Online ahead of print.
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The presence of certain clinical findings can help clinicians gauge the likelihood of bacterial versus viral conjunctivitis, although data are limited.
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Topical NSAIDs improved pain from corneal abrasion. The jury is out on other options per this review.
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Short-term use of topical tetracaine for uncomplicated corneal abrasions was associated with significant pain reduction and decreased need for opioid medications, with no difference in wound healing or serious complications. However, larger studies are needed to definitively demonstrate safety and rule out rare adverse events.
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If you accidentally glue someone’s eye shut, soaking the eye in dexamethasone, polymyxin B, neomycin antibiotic drops was most effective at loosening histoacryl tissue adhesive.
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style=”white-space:pre-wrap;”>The rate of non-powder firearm (i.e. BB, airsoft, paintball) injuries has decreased overall in the past few decades, but eye injuries have increased – many of the them quite severe.
The overall sensitivity of the Wood’s lamp, compared to the gold standard slit lamp, to establish the diagnosis of common corneal and conjunctival abnormalities was found to be an abysmal 52%.
